Birth control, physiology changes, and trade-offs

[missroserose]

Caution: Frank talk about girly bits ahead. I'm not putting this under a cut because I think it's ridiculous and frankly sexist that much of the population has been socialized to be squicked out by discussion of the perfectly normal biological functioning of bits that half the population owns. However, if you're a victim of such conditioning, or a lawmaker from Michigan, you may want to skip the following. (And if any of said MI lawmakers drop by and want to protest that they weren't being sexist, name me one instance of a dude making a flippant comment about his penis that got him barred from speaking in a debate relating to penile health. Just one. I'm waiting.)

I woke up this morning with a brief ache in my upper left arm, where my Implanon birth control implant sits. Nothing serious, but enough to make me palpate the area and make sure nothing was amiss. When I pressed it, however, and didn't feel the implant there, I realized that the ache was where the implant had been placed when I first got it nearly three years ago, and not where it's migrated to (further down the arm) since then. Definitely a relief that nothing was wrong, but perhaps also a psychosomatic indication of my increasing distrust of its stability.

For two and a half years it's been great, but the past six months or so have been mood-swing city (on and off rather than continual, fortunately, or else I probably would've got rid of it far earlier). I'm due for removal in October, although I'm probably going to go in sooner than that; mostly I'm just waiting for our insurance cards. And while I could get another implant if I wanted to, I don't think I'm going to go that route, especially since there's an IUD with the same hormonal aspects that only costs a little more and lasts for five years instead of three.

I'm feeling kind of ambivalent about hormones in general, though. Unlike many women I know, I've had a pretty positive relationship with hormonal birth control in the past. My periods tend to be on the heavier side with a goodly dose of cramping; not enough to be disabling or anything, but definitely in the "moderately miserable" category. However, since discovering that low-dose birth control pills reduced them to occasional spotting (when it didn't stop them altogether), I've been on one form or another of the stuff pretty much continually for nearly a decade. And this is the first time I've ever had mood swings like this, which leads me to believe it's probably a function of the implant nearing the end of its life cycle.

Thing is, it has been nearly a decade, and I'm not the same person physically that I was then. I'm probably pretty similar, but there have definitely been hormonal changes in the interim - multiple orgasms, anyone? So I'm a little hesitant to immediately jump on board with another hormonal birth control method; it seems like it would be better to give it a few months and see if I feel better or worse without the constant dosage of chemicals.

On the other hand, I really, really like the convenience of the implant - no pills to take or barriers to futz with, just set it and go. There's a nonhormonal IUD that I could try, but [a] it's expensive enough that I'd rather not get it unless I was planning to stick with it, and [b] it's been known to cause heavier bleeding and cramps in some women; not exactly a resounding recommendation. Sterilization's an option, but for women it's expensive enough that I'd ultimately rather go with an IUD, especially if I decide I still want the hormones. (Plus, while I've never had a bad reaction to anesthesia that I know of, something about it just freaks me out a bit.) So that leaves the usual suspects for the proposed interim - condoms, diaphragm, sponges, et al. I might look into a diaphragm; it sounds like a bit of a pain, but it's inexpensive enough to work as a temporary nonhormonal option, and I've never minded mucking about with my vagina. (See above re: multiple orgasms. :)

So now I'm opening the floor - is there another option I'm not considering? What's your history with birth control (from either sex's perspective)? I'm well aware that no one method is perfect for everyone, but I'm interested in hearing about other folks' experiences.

Comments

[pleiadeslion.livejournal.com]

It seems that the side effects from the hormone progesterone (which is the main active part in implant, ring, injection, mini pill and patch) can be many and varied, and can pop up months or years after you first start taking it. One of my friends recently had to have her implant removed because she was putting on loads of weight - 8kg in a month -_-. Another friend, when she stopped having the injection, her whole personality changed.

I have a non-hormonal IUD. I don't think I've had much heavier bleeding, maybe some cramps but nothing that a couple of acetaminophen won't fix. They last 10 years nowadays, so if you can find the cash from somewhere, it is well worth it!

I tried a diaphragm but I can't say I'd recommend it, save that it will hold back your blood flow if you want to do it when you're menstruating. I found it was uncomfortable to put in and then there tends to be a bit of a taste and smell of spermicide around your nethers even if you wash, so oral sex as foreplay is probably off the menu. One thing they don't tell you is that the smell when you take it out (I think you have to leave it in a couple of hours afterwards at least...) can be rather overpowering.

[roseneko.livejournal.com]

I've heard a lot of horror stories about the shot, and I don't like needles anyway, so that one's never been a question for me. I've read a lot about the many and varied (and sometimes quite subtle) side effects of progesterone, and I admit that I've been on it so long I'm sort of curious if I will be different somehow if I go off of it. Hormones are powerful things, after all...Brian's a little anxious, understandably as I've been on them the entire time we're together, but I've promised to listen to him if he says I'm getting difficult to live with if he promises not to assume I'm immediately going to become a tetchy weepy hormonal wreck.

The IUD's definitely going to be something I investigate if I decide I don't want hormones in the long term. Planned Parenthood's website says that the one that's available in the US lasts up to 12 years, actually, so that definitely seems like the best cost/benefit ratio. Fortunately Brian's got a good job with insurance that actually covers birth control (unlike my supposedly-great insurance when I worked for the County and got Implanon three years ago...cripes, I'm still pissed off about that), so cost is a factor (there's still the copay and deductible to consider) but not a huge one.

Thanks for the info on the diaphragm! I hadn't heard any stories of firsthand experiences, so that's good to know. :)

[amanda_lodden.livejournal.com]

I would definitely give a non-hormone option a try for a few months. I ultimately went with sterilization because I disliked the side effects that the hormones were giving me: moodiness and reduced libido as I got older. I don't have any specific recommendations for non-hormone options though, since I stopped needing them several years ago and had made-do with condoms when I wasn't using hormones.

If Brian's insurance covers birth control (prior to being forced to do so), then it would probably cover sterilization for either of you as well.

[roseneko.livejournal.com]

It does cover sterilization, but that's still going to be pricey - $300 deductible plus 20% copay on a multi-thousand-dollar procedure (I don't know how much it is here; PP's website estimates $1500 - $6000, depending.) If I decide to go that route it'd probably take a bit of saving, but it might be worth it for the lack of hassle.

[ivy]

I had the Essure procedure done and I've been happy with that. I had it done with just a local, though, out of fears of how I'd react to general anaesthetic. DON'T DO THAT. Get the general. Wish I had. (Local: they numb your cervix. They do not numb your vagina, your uterus, or your Fallopian tubes, all of which are being stabbed into with a spring for this procedure. So you're basically having one-part-anaesthetized, three parts totally not anaesthetized surgery. SUCKS. And you can't move or scream because if you do it will screw up the surgeon and make everything far worse.) I have a ridiculously high pain tolerance normally, and even I was a very unhappy camper. If I had it to do again, I would definitely have the surgery again, but I would get them to knock me the fuck out first.

[roseneko.livejournal.com]

Good to know. :) You are way more hardcore than I am. Slight phobia of anesthesia aside, if it's between that and stabbing pains in my nether regions I'll totally face my fears and take the gas.

[joyfulleigh.livejournal.com]

I have never felt better since going off hormonal birth control. WAY better sex life all around, way less moodiness except on the day my period arrives, periods less heavy, and 5 pounds lighter. Down side: I get crazy bloated around ovulation time (strange but Dr. Google says not uncommon).

I had a bad experience with the Paragard and don't recommend it unless the woman is super wealthy and can afford to lose the cost if it doesn't work for her. Some bcp's gave me migraines - Yaz was the WORST. I tried Nuvaring for a while and it worked well. If I were going to go back on the hormones, the ring is what I'd do again.

But honestly? Vasectomy FTW. Best decision ever in our household.

L.

[roseneko.livejournal.com]

Good to know! Vasectomy's an option too, of course, and it is a lot cheaper than a ligation, but Brian's a little iffy on the idea of anyone cutting into his scrotum, and frankly I'd rather have my own form of birth control (whatever it ends up being).

I tried the ring once when they had a special for a free month's supply, and I did like it, but the $45-a-month cost ended up being a little much for me to swallow on a college-student budget.

What happened with the Paraguard, if you don't mind my asking?

[joyfulleigh.livejournal.com]

I bled for a year with the Paragard. I desperately wanted it to work, which is why I kept it in so long, hoping and praying I was still "adjusting to it" and the side effects would go away. I wanted to be hormone free but still have the onus of birth control on me and not use a barrier method, so it seemed perfect. But I not only had heavier and grosser periods, but in between periods I spotted non-stop. Not a lot, mind you. Just a tiny bit every day or every other day. But enough to have to wear a pantyliner every day and make me feel generally unclean. As you can imagine, it was horrible on my sex life.

I thought I was just weird, but I have another close friend here in Virginia who had the Paragard for six months and had the exact same thing happen.

I've heard it works absolutely great for some people, but given my experience and that of my friend, I feel like anyone who puts it in should be prepared for it not to work for her. And given the cost, it's a rather expensive experiment.

L.

[roseneko.livejournal.com]

Definitely good to know. I have a couple of friends who love their IUDs, but then, I loved my hormones until just recently, so.

There's definitely some trial-and-error involved. Insurance helps, though.

[jamesd.livejournal.com]

As a male what I most value about what you've been doing is very high success rate. Next predictability of what hormones do to you.

I like the idea of your experiment on yourself. No telling what it could do, good or bad, and it's intellectually interesting to discover such things as well as potentially beneficial.

[roseneko.livejournal.com]

You think *you* value it...*I'm* the one who has to figure out what to do if things go wrong. :P Fortunately it hasn't been an issue for me. I've known women in the past who joked that they should nickname their kids Condom, Pill, Diaphragm, and IUD.

When it comes to physiology especially, I'm a big believer in "there's no one right answer". Everyone's a little different and reacts differently to different medications, and that can change as they grow and change as well. So it only makes sense to experiment on myself and see what works. :)

Mum's the Word

[faith-rose08.livejournal.com]

The world has changed, I can smell it in the air, I can feel it in the earth . . . Way back in 1976, In the early days of birth control pills, they were so strong that they reduced me to a whiney, weepy, emotional mudpie - so that didn't work. Tried the diaphragm but the lack of spontaneity was exceeded by the bloody, rash I got from allergic reaction to the spermicide. Tried condoms but I don't like having my sense of touch and taste interfered with so finally, after we had our two wonderful kids (the second with surgical intervention), your Dad got fixed. It seemed only fair, given that I was sporting the bikini scar from the $5,000 man (as we called your brother). Now, I can tell you that the BEST is yet to come! Menopause was so messy and uncomfortable and lasted for nearly seven years, but once it was done - SEX IS THE BEST!!! No worries, just Love! Who knew? Love, Mum,