It's a BCP cake! Nom nom nom. Via browntown @ Flickr.
Welcome to Harpy Seminar, a regular feature we plan to have at regular intervals, unless we get too busy to have it at regular intervals, in which case it shall appear whenever we have time and inclination for it. Each Seminar begins with a question, which we discuss amongst ourselves, and we then edit the highlights of our conversation into a post. Please feel free to join in in the comments!
In today’s Harpy Seminar, we’ll be having a frank and open Our Bodies, Ourselves-style roundtable about contraceptives. Overshare-y! Informative! Pull up a chair, won’t you? Today’s question: what’s your pleasure when it comes to birth control?
BeckySharper: My mom took me to her gyno when I was a sophomore in college so I could get a prescription for the Pill. The gyno was the very same woman who’d who delivered me 19 years earlier, so it was kind of hilarious in a circle-of-life way. I’ve been on the pill for almost 15 years now, and it’s been nothing but terrific. For STI protection, I use condoms religiously unless I’m in a monogamous relationship where we have had The Talk. I don’t particularly like them, but I’ve discovered that after all those years of using condoms, I have a quasi-Pavlovian response to the smell of latex.
sarah.of.a.lesser.god: I’ve had sex exactly 5 times. First two times we used a condom. The very first time the condom broke. (Does that mean I have a masochistic vagina?) Thankfully I felt fortunate to get pregnant, but boy was that a wake-up call! After that, of course, condoms were not quite necessary since he had agreed to be tested. Oh! And lubed condoms are perhaps the only kind I will ever use.
BeckySharper: Oh yeah, the more lube the better. I keep a big ol’ industrial size bottle in the drawer with the condoms because latex really can dry you out much more than an unwrapped peen.
Ph.Dork: Hate. Condoms. Have used them when necessary, but haaaate. They rub, they stink, they make me itch.
Fortunately, I’ve been mostly monogamous (a story for another time, my pets) nigh these last 11 years, so I was on the Pill, which I started my Sophomore year, although I went to the PP in my college town because I did not (and do not) have that kind of relationship with my mom. I’ve always known that kids are not for me, and the dude is of the same mind, so after a LOT of discussion, he finally got a vasectomy, and we are now hormone and condom free, and everybody’s happy.
PilgrimSoul: If I take any kind of pill, my blood pressure goes immediately through the roof. So no pills, never again.
SarahMC: I’ve been on the Pill since I started having sex. I’ve used condoms a few times, but only when I’d missed a Pill or been on antibiotics or something. I much prefer NOT using condoms, and since I’ve been with the same person a long time and we’re monogamous, the Pill is the only method I (we) use.
I feel pretty good on the Pill. I suspect it MAY result in a lower sex drive for me but it’s hard to tell because I’ve been on it since I started having sex. My periods are easy breezy; they are short and I don’t get PMS. In fact, the one time I stopped taking the Pill (when I studied abroad) my period was so hideous I went right back on it.
BeckySharper: I know some women react badly to the Pill’s hormones but that was never an issue for me at all; I lucked into less PMS and cramping with the Pill, and I definitely have a lighter flow, which is always welcome.
PhDork: The only thing I miss about the pill was the clockwork periods: 4th Thursday at 3 pm. Now it’s back to educated guessing: some time this week…
sarah.of.a.lesser.god: Now I am considering the pill. My periods have always been like clockwork and I don’t think I’ll be fornicating again anytime soon but I would rather not get pregnant again for a long while.
BeckySharper: I really think Margaret Sanger is looking down on us, raising a fist in triumph. Birth control FTW!
So ladies, what’s your contraceptive preference? Are you Trojan women? Pill-poppers? Join our circle of candor in the comments…
sorry sarah!!!! you’ll notice i did NOT tell you to quit, just to change bc. and that i don’t take my own advice.
Apparently birth control is all I care to talk about, because I have migrated over from Jez to talk about it some more over here. I have the Paragard IUD and am in love with it. Hormonal birth control turns me into a sobbing mess mixed with an angry, manic mess and I hate condoms. I tried many many kinds of pills and the ring and nothing worked out. I spent one slightly paranoid month thinking the thing was expelling, but it’s still in there so far and has been great. It’s a really cost effective alternative to pills and/or condoms.
So now in addition to possibly trying the Keeper, I may have to get an IUD. This is exciting!
Then you can check out the little strings at any speculum parties you might attend. Bonus!
@SarahMC: Supposedly, according to internet people’s anecdotes, the suction of the Keeper (or Diva cup) can pull the IUD out. I think this is only if you break the suction incorrectly when removing it, but I am too scared to try one.
I’m on the pill most of the time. I’ve had ok luck with Ortho-tricylen and its generic version. I get some weight gain (5-10 lbs) but that could be attributed to other things. I had horrible luck with Zovia and Yasmin. The Yasmin was fine at first but started having lots of sneaky side effects, especially after I lost weight. I got dehydrated, had trouble wearing contacts, had the worst case of dandruff ever (it magically went away once I switched BC), had lots of mental fuzziness, and the worst vaginal dryness ever, although I still had plenty of libido.
I’m switching to the ortho tricylen lo in a month since I’m 40 and want a lower hormone option. I had to order it from Canada since my health plan doesn’t cover that particular type.
I go off the pill for a month every year. This is my month off since I’m having knee surgery next week and my doctor recommended I go off it. I gotta say that the sex is always better when I’m not on the pill. I think the pheromones are playing a role.
For that reason, I wish I could get a copper IUD and go totally hormone free, but I haven’t had any kids and don’t have enough pill-related risk factors to convince my doctor to give me one.
::foghorn noise::
If I have to pick one and only one device to stick up my catbag, so be it.
@annimal: I haven’t had any kids, either. Not wanting to pump hormones into your body seems like a perfectly good reason to get a copper IUD. Maybe try being more assertive with your doctor? I’ve changed doctors for less.
IUD is probably a good alternative but the thought just freaks me out. I’ve read about it in a couple of places, and while there were plenty of positive things said about it, I couldn’t get past the negative stuff, since with my luck, things would go horribly wrong. Not to mention that it might be difficult to find a doctor willing to put it in, since I haven’t given birth.
@annimal: I’m surprised to hear your doctor won’t give you an IUD because you haven’t had kids. I’m 25, nulliparous but eventually want kids, and my midwife had no issues with inserting an IUD. I thought most providers no longer thought women needed to wait until after birth to get IUDs.
@anniemal: Seriously, your Dr. won’t give you one? That’s ridiculous. The thing about “having had a kid” is only for ease of insertion. It has nothing to do with the actual effectiveness of the IUD or the risk factors if you get one, or anything.
It just burns my butt when docs withhold something that’s not going to do you any harm and may do you some good just because they’ve judged you don’t need it badly enough. Argh.
@Unpossible: I think there’s also a slightly higher chance that you will expel the IUD if you’ve never given birth, but it’s a very very small chance.
@NellMood: Hmmm, interesting. It would actually make more sense to me if it were the opposite – like, your body has already pushed one thing out of your uterus, so it’s more likely to do it again?
@Unpossible: My midwife said that because you’ve never had anything in your uterus before it sort of freaks out and tries to push it out. It’s entirely possible that I misunderstood the science of this. I do know that if you had a baby there is a higher chance that the IUD will perforate your uterus, but only if you get it immediately post-birth when you uterus is still stretched out.
These risks are so minuscule, though. Overall I think the IUD is definitely worth it.
Count me in the IUD camp–I love love love my Paragard. It’s the non-hormonal IUD option: the Mirena releases low-level hormones to keep things extra safe, but the Paragard just contracepts all by its copper-plated self. That means that you continue getting your period (some women even get it heavier for a while). For me, the tradeoff is totally worth it, because bc hormones fuck with my mental health.
As for the whole nulliparous thing, I second Unpossible–that’s bullshit! And I’ve got the tale of woe (ToW) to prove it:
ToW: having tried condoms (hate), a diaphram (allergy to spermicide), and the Nuvaring (chafing in places no one should chafe, aforementioned mental health blues), I went to my gyno and begged her to give me an IUD. She refused on the grounds that I hadn’t given birth. I nodded my head, figured there was some medically crucial reason I wouldn’t understand, and decided I’d just have to make do.
I ended up back in her office a year later getting signed off for an abortion, because I’d gotten pregnant trying to use fertility awareness (I’m not real good at record keeping, it turns out). Two months after the abortion, she gave me an IUD without a murmur of medical incertitude. Let me make this clear: the IUD insertion hurt a whole hell of a lot less than unplanned pregnancy. I’d do a lot to go back to that first appointment and give her a piece of my mind.
What I’m not going to do is go back and have the thing taken out–it’s freaking terrific for all the reasons everyone else has pointed out. My method of choice from now until menopause.
I hope I’m not too late to this discussion because I’m having serious birth control drama. I was on the pill very happily for 7 years, and then started getting insane leg pain during my period. Because the pill had been so great for so long, it took me a while to connect the two, but once I went off, I immediately felt better (and got my libido back–something I had been beating myself up about, and also failed to connect to the pill). I tried the NuvaRing, and got the same symptoms, so now I’m done with hormones for a while. I don’t want an IUD, because I want children in the next few years, and my partner doesn’t want to rely on condoms. So I just got a diaphragm and a huge unsexy tube of spermicide. I feel so 1985. The pharmacist insisted they don’t exist anymore, and was shocked when she was able to order one for me. It’s not the size that scares me (lover of the keeper as I am), but the ring is so thick… and spring-loaded!… I’m nervous about using it painlessly. And how will I know if it’s in the right place? I haven’t even mentioned the best part: only 80% effective. Please help.
@Spark: You sure you don’t want an IUD? They can be removed when you want to have kids–if you get one that’s good for 3-5 years, you can have it removed a year later if you want to get pregnant.
@SarahMC: We should just start a regular feature called “stuff that goes up your catbag.” Because commenters have seriously educated me in that regard recently!
@Spark: You can always opt to get an IUD and have it removed early. I probably won’t keep mine in for the full ten years.
I’m on NuvaRing these days, but I started with Yaz. Spent two months on Yaz with a happy three-day period, and then realized it was causing my crazy ass migraines. Yea, I’m off that shit. Switched to NuvaRing the next month at the recommendation of the gyno at my college health center, and I’ve been happy with it.
I’m only on BC to regulate my period and reduce my crazy PMS. It’s working out pretty well for me.
I am one of those women who get almost every bad side effect on the pill. I get morning sickness on the lowest dose, although I haven’t tried the lower three a day one because my memory couldn’t cope with that.
I am currently on Depo Provera, which I love, but I don’t want to keep pumping my body full of hormones for the next 40 years, so I am planning on getting ‘fixed’ as soon as I can find a doctor who accepts that someone as young as me is fully capable of making life-altering desicions. I know that I will never want to have children and I would not regret making that choice.
@BeckySharper, NellMood: My resistance to an IUD probably isn’t rational… I worry about how much it would hurt, and I feel more comfortable with birth control I can personally control. I’m in that weird (for me) place jdregent described–wanting kids but trying not to get pregnant, and also scared I won’t be able to get pregnant when I’m ready. Making an appointment to remove an IUD is a much more official “we’re trying!” statement then leaving the diaphragm (ugh) on the bedside table.
Spark I hear you. I’ve thought about IUD but sort of don’t feel that sure I will know when I want to get pregnant. I’d rather keep things more fluid, and one day just “decide” to stop taking my pills and see what happens. This may be major denial on my part about fertility in 2009. Maybe fertility awareness is a good option for you? (Not to be too creepy and Catholic about things, it comes more from a hippie place than a religious one). You could just use condoms on the days you are fertile. Or you could use spermicide without diaphragm, right?
la sooz: I remember the sponge, although they went away when I was in college. I used that a couple times, and VCF (Vaginal Contraceptive Film, which was a little clear square of poison you jammed up your catbag, as we’re now calling it) before I went on the pill.
And your recommendation: was that for the Pill? Or getting naked with a 31 year old dude?
@jd: I’m going to start tracking my cycle so we can use condoms + diaphragm during more fertile times. I think spermicide alone is like 60-70% effective–actually not all that worse than with the diaphragm. I’m going to look for the Weschler book.
I definitely have warped feelings about fertility. I feel entitled to 99.999% effective birth control, and now that I don’t have that I’m nervous and resentful. But I’ve internalized the “conceive before your next birthday or be barren” message, so part of me says don’t use anything at all.
I’m a pill girl. I don’t hate it but I really think it’s killed my sex drive. I did get bigger boobs outta the deal, which for me was a plus.
re: Unpossible’s earlier comment ”
@anniemal: Seriously, your Dr. won’t give you one? That’s ridiculous. The thing about “having had a kid” is only for ease of insertion. It has nothing to do with the actual effectiveness of the IUD or the risk factors if you get one, or anything.
It just burns my butt when docs withhold something that’s not going to do you any harm and may do you some good just because they’ve judged you don’t need it badly enough. Argh.”
No, it’s not only about ease of insertion. There’s a chance an IUD could render you permanently infertile. So a doc often refuses to give one to someone who already has a kid because they don’t want to get sued by someone who never had a kid and ended up unable to have one after removal. It’s a CYA thing that may be standard policy for many practices.
um, amend that to “someone who doesn’t already have a kid.”
Hey you guys!! Check it out!
Wm. Saletan has a thing in today’s Slate about it but although I like him generally his article rubbed me entirely the wrong way, so I don’t recommend it.
have you used the female condom kithkin? i’m definitely glad they exist but for those of us in committed relationships, i sort of feel like if everyone hates male condoms, won’t we hate these more? Also wtf is up with Wm. Saletan being obsessed with womens reproductive issues? What is his background?
Ha! Saletan rubbed you the wrong way. Snerk.
@funnyface: But as I understand it (correct me if I’m wrong), while the risk of infertility from an IUD exists, not having had a kid doesn’t actually make the chances any higher. So, while it’s true that someone who hasn’t had any kids and is using birth control is probably more likely to want kids in the future than someone who already has kids, it’s not like the actual risk factor is different. And (hopefully) the doctor will make the patient aware of the risks no matter what the situation. So, yeah, it still seems to me like it’s to the doc’s advantage to refuse the IUD, not the patient’s.
@funnyface: That’s true. If you get a STI while you have an IUD it can really affect your fertility. That’s why it’s important to test for everything, have your partner get tested, and be vigilant about condoms if you get out of your monogamous relationship.
@spark: I understand your fears, definitely. I did a LOT of research before I got mine. I was initially resistant to have this piece of metal/plastic lodged inside of me, but ultimately it seems like the right choice for me.
@Kithkin: those actually look like a real improvement over the female condom 1.0 model (which Dan Savage and his boyfriend took for a test drive and described as being “like fucking a plastic sandwich baggie.”). I’m sure they could be a huge positive for women in the third world who live in areas with high rates of HIV infection, esp. sex workers.
I notice they’re made of polyurethane, like the polyurethane condoms I mentioned earlier. That’s good stuff. Also, you can seal your patio furniture with it.
oh has this been the greatest post for me to ready lately! I just went to PPar (as someone else called it. nice by the way) today to get the Mirena IUD. I’ve really been struggling with the decision, but this has made me feel so much better. And, even better, the bf went with me all the way to the nearest PPar to make sure I was ok with it all!
I get all my healthcare from the College Health Services and the doctor there reccommended it for me as I get wicked migraines about 2-3 times a month. I’ve never had children and she said that PPar will do it for me, no big deal. So if anyone is having trouble with their own doctors not telling them about the IUD option I’d suggest calling PPar.
Unpossible: you’re right, it is to the doc’s advantage to refuse to give it to a childless patient, not the patient’s advantage. It’s about protecting themselves from lawsuits (malpractice insurance is already putting many OB/Gyns out of business), not so much protecting patients from increased risk.
I haven’t used it. Still, I think that if it’s any good, it may be better than condoms simply because they don’t require an erection to work, and you can put it in before sexytime. One of the things I hate most about regular condoms (other than the smell and the need for a lot of lube) is the awkward tearing open of the package and rush to get it put on. If you could excuse yourself and put this in just as you’re about to put the moves on your dude, then it could save that awkward time. This also has the benefit of easy cleanup, which is my most favorite thing about condoms. It’s the only thing I miss, really.
And I have no idea about William Saletan. I read his book and really, really liked it, but the more I read his column the less I like him. Like he’s the kind of dude who would like to tell me how it really is to be a woman. I checked his wikipedia and it offered no insight into his background, really. He’s from Texas, went to Swarthmore, and describes himself as a liberal Republican.
When I was on the pill I was incredibly volatile – I would get angry almost to the point of tears at NOTHING, then depressed, then completely fine 20 minutes later as if nothing happened. Everyone kept telling me the hormone rage/depression would fade once my body got used to it, but I only managed to last three months before I kicked pills to the curb.
I’ve always used a condom, and plan to continue. It’s possible that I may try a different brand of pill (or nuvaring or patch or maybe even an IUD), but after those hellmonths of moodswinging it probably won’t be any time soon.
I was a teenager when I started on the pill, and it was a miracle cure for mood problems. I was worried about how going off would affect me emotionally, but so far I’m ok. (Also hoped I would lose weight–no such luck.) Now I just have fingers crossed that acne won’t return.
William Saletan is worthwhile to me because Amanda Marcotte at Pandagon eviscerates him everytime he writes a new piece. Highly satisfying.
I swear I’ve used everything, so here’s my thoughts:
Pill: Makes me nauseous and kills my libido. Fuck that. Also, I don’t trust Big Pharma.
Ring: Better, but same hormone effects. The best part is that you can leave it in for four weeks with no loss of protection. Yay for fewer periods!
Spermicide: A little goofy to insert. Low protection. Tastes awful and makes his tongue numb.
Diaphragm: Hard to find because people think you have traveled from 1975. Otherwise, my preference provided you’re STI-free and getting pregnant wouldn’t be the end of the world.
Film: Hard to insert b/c it sticks to your finger.
Condoms: It seems like you have to try a few brands to get a good fit. Also, some men act like big babies about them.
Withdrawal: I’ve never understood why men even want to do this, but PPar actually does rate it 95% effective if done correctly every time. I think the control involved is kinda sexy, and men have been so pornified that maybe they like having a ‘money shot.’
Whew! Did I set a new bar for oversharing?
@Spark – I gotta admit, I’m with you on the IUD thing. I just know of a couple of horror stories from close friends and family. So I also got a diaphragm. I gotta say, I can always feel if it’s not in the right place. I can feel my cervix through it, and if it slips out of place, ouch! But I may not be typical.
So after 18 years of being super-paranoid, double-barrier method girl — so proud of never having been unintentionally pregnant, master of diaphragms (which when used correctly are more like 90% effective), condoms, and BCP — when we did try to have a kid, it just didn’t work. I read Taking Charge of Your Fertility (which I highly recommend), charted body temps and fluids, and dutifully tried to conceive on certain days for a year. Then we went for 9 months of fertility treatments (talk about hormones and stress killing libido!), which finally paid off with our lovely little boy. I feel so stupid for wasting all that energy and money, but how could I know?
So at this point, I’m glad to say we’re not using any BC at all. (Been with the mister for nine years, and very comfortable he’s not infected – he’d have to leave the house.) It’s very freeing. If we have another kid, YAY!! And if not, it’s fun not to worry about it.
@PhDork: I guess now that I think about it, I meant both, the Mononessa pill and the younger guy! Two great tastes that go great together.
@Nimue: No overshare at all, it’s a fascinating report, really. I love the 1975 reference.
Oh, and I also wanted to add that when I asked my Gyno about “‘How much trouble is it to get my tubes tied??” she said some women do it and then end up going back on the pill to regulate their periods, (i had heavy ones before pill). I just looked up to The Big Guy In The Sky and said “Gee, thanks.”
@Nimue: I know a number of people who swear by withdrawal and have used it effectively. I think its effectiveness comes down to complete trust. I have to trust that they know their own bodies very well, that they are not in any way risk-takers, and that have very good control. I just don’t feel comfortable making those assumptions, esp. if he’s not someone I know well (because, yeah, I occasionally fuck guys I have only known for a short period of time. Shame me, ladies!)
Also, with regard to withdrawal, some men are dribblers, if you know what I mean. And many of them DON’T KNOW that they dribble, which kind of amazes me, because I certainly notice it right away and I’m a lot less well-acquainted with their junk than they are.
I’m also a secret fan of pullout. (i know, I know). I mean it’s not really a long term solution but it will do in a pinch. With a dude you know REALLY well.
@ mkp-hearts-nyc I’m also a fan of condoms… My favorite thing about them is the way they clean up the mess that boys inevitably leave behind.
THIS. yes. yes, yes, yes.
So after reading this entire page I’m crazy excited to get a copper IUD, which my gyno has offered to me twice and I’ve declined.
I can’t take birth control with estrogen without getting hypertension, and I’ve been in my relationship for two and a half years, and now I might take her up on her offer. I’m on the progestin only pill right now, and I’m very good at taking it, but… this may sound very hippie of me, but I kind of miss my cycle. The pill has gotten rid of my periods (a normal side effect) and I kind of miss the connection to it. I keep feeling like I’m missing something, which is strange, I know, but I really can’t shake it.
Here’s my problem, and I hope someone has advice.
I am in LOVE with my DivaCup. Lovelovelovelovelove. But the thought of it pulling an IUD out, and I’m clumsy with breaking the seal…. (granted, I haven’t used the damn thing in like two years). Are there any other reusable, long lasting (as in more than three flippin hours for someone who’s heavy, haha) enviro-and mentally friendly methods for your period?
@mydishonestheart: I think the chances of actually pulling the IUD out with a DivaCup are pretty small, but I’ve never used one. There’s a good community on livejournal called IUDdivas (or something like that…) that has tons of posts; maybe someone there has had better experience using reusable cups with their IUD and can offer good advice.
@elibard: Thanks. For all the time I spent with my hand in my vagina the last few months (NuvaRing, Keeper, life, etc) I still don’t know where my cervix is. The instructions with the diaphragm say it should feel like your nose when you press on it (!). But I figure if I can’t feel the diaphragm, and the ring is open, then it’s in ok.
@mydishonestheart: I’ve never used them, but I’ve heard good things about Luna Pads. http://www.lunapads.com/
ok, you guys have inspired me. I’ll ask my gyno about a copper IUD at my next appointment. I hadn’t even bothered to ask since I’d heard of so many people getting turned down.
on a related note, has anyone heard about this permanent sterilization procedure in which little pieces of metal are inserted into the fallopian tubes and then scar tissue grows around them? sounds really horrible, but one of my friends is considering it since her man is paranoid about getting a vasectomy. i told her to hold off until she finds out more.
@annimal: We are here to inspire, overshare and offer amateur advice of all kinds. Srsly, though, glad this was helpful.
I haven’t heard about that sterilization procedure. Don’t know why that would be preferable to plain old tubal ligation. And regardless of whether she chooses that or an old fashioned tube-tie, a vasectomy is a lot less invasive. Her boyfriend should just man up and get the snip, IMO.