Thoughts on Birth Control and Why I’m Looking For Alternatives

Sex is fun. It’s a way to wind down, wind up, release, gratify, invigorate, sedate, punish, validate, please, connect, play, comfort, elevate, and transform. Annnnnnnnd it makes babies. How terribly inconvenient.

As amazing as sex can be, it’s easy to forget the primary cause of intercourse: reproduction. We, like all other animals, have a nearly irresistible urge to mate and multiply, regardless of whether it’s really a good time to be multiplying, in a personal and global sense. The bottom line is, if we don’t yet want to have children, it would be wise not to have sex. But we wanna fuck, dammit!

For thousands and thousands of years, women and men have been trying to get off without getting knocked up. Pulling out is arguably the most antique method. (I’m not even going to consider abstinence a form of birth control, because there is no potential birth to control.) Prostitution is the oldest profession, right? That means birth control has to have a pretty lengthy history. After much investigation, I found many remarkable and often questionable ways that women have avoided having children while having sex. Most were pregnancy abortifacients rather than preventatives. Here are a few of the highlights I learned:

• Half a lemon rind was one of nature’s first diaphragms

• A cocktail of Queen Anne’s lace and pomegranate will cause a miscarriage, as well as other herbal elixirs including dong quai, pennyroyal, mugwort, and more; drinking these were risky, as the woman often died in addition to the fetus

• Wads of cotton or beeswax were used as cervical caps

• The French made the first condoms out of animal intestines in 1640

• Silphium, a plant related to fennel, was ingested by Mediterraneans to prevent and abort pregnancy

• Spitting three times in a frog’s mouth, avoiding moonlight, and jumping backwards seven times while squatting after intercourse are only a few of the more superstitious methods

• Egyptian women used crocodile dung coated in honey as a suppository

• Douching after sex with Lysol was believed to kill sperm

At long, long last, on June 23, 1960, Enovid was released, the first FDA-approved oral contraceptive. The Pill had arrived. How our ancestors must have dreamed about the day they would only have to swallow a little tablet with a glass of water to never worry about getting pregnant again.

However, as most of us know by now, hormonal contraceptives aren’t without their downsides. While childless sex, eased menstrual cramps, spontaneous love making, cleared up acne, bigger boobs, and the control to decide when—even if—our periods happen are some of the heaven-sent positive effects, many are becoming increasingly aware of the detrimental long-term consequences of chemically manipulating our bodies’ fertility. Countless books and well-researched articles have been written on the dangers of hormonal birth control, which right now include oral (various pills); injectable (Depo-Provera, aka The Shot); adhesive (the Patch); vaginal (NuvaRing); implanted (Implanon); and professionally inserted (the IUD Mirena, which contains hormones, unlike the IUD Paraguard). While every woman's body is responds differently to different types of BC—some can be great on Yaz for example, while others feel suicidal—some of the more common, not-so-fun side effects of these include:

- mood swings so bad they cause you to question whether or not you’re bipolar

- raging PMS, although some girls occasionally report a decrease

- diminished or non-existent sex drive, which might as well defeat the purpose of taking BC anyway

- vaginal dryness (again, defeats the purpose)

- depression and anxiety

- weight gain that is definitely not limited to your boobs; also, I never had cellulite until I started taking The Pill

- overall irritability and increased emotional sensitivity

- loss of feeling sexy and receiving sexual attention like we used to, probably due to the fact that we aren’t ovulating and therefore aren’t producing as many pheromones, whilst sending out the unconscious signal that we’re pregnant

- nausea, bloating, hair loss, acne (not all of us get clearer, some of us get worse)…

The list goes on and on. And why do we put ourselves through it month after month, year after year, decade after decade? So we won’t get pregnant.

I must acknowledge that some of us don’t necessarily use BC as a contraceptive, as its other benefits were pointed out above. I took my first foil-popped dose of Ortho Tri-Cyclen when I was barely seventeen and not sexually active; the doctor said it would cure my acne, which it didn’t, but I did gain fifteen pounds and felt constantly exhausted. I’ve also taken the Pill simply to regulate and ease my highly unpredictable, painful periods. If you're a female who has ever been treated with Accutane, you know you are also required to simultaneously take a hormonal type of BC (Google-image “Accutane baby defects” and you’ll see why). Other girls may be on the Pill because they’re anemic and can forgo the monthly loss of blood with a prescription of Seasonique, which allows you to menstruate only four times a year instead of twelve. If you take Lybrel, you may never even menstruate at all. Point is, there are many reasons women take birth control that are unrelated to preventing pregnancy. While I don’t encourage anyone to stop treatment of a major health issue, I do encourage everyone to get second, third, and fourth opinions. Explore what options you may have with herbal remedies, consider bio-identicals and other hormone alternatives to the free BC samples your pharmaceutical-contracted doctors hand out as a cure-all for just about every female discomfort. So far I haven’t met a doctor who would even hesitate to put me on the Pill. This week, I have plans to change that.

Two years ago I read Suzanne Somers’ book Breakthrough: Eight Steps to Wellness. I know, I know, she’s got mixed credibility and rightfully so. Everyone’s opinion and research should be questioned, examined, and reexamined. While Suzanne may not have a doctorate, she has interviewed so many doctors and specialists that I consider her work thorough enough to get me to at least question my use of hormonal birth control, far beyond the common negative side effects I listed above. When I read her book, it was the first time I had ever seriously reconsidered my use of hormonal contraceptives. I began to research other sources who also highly oppose the use of BC. Many experts besides the ones in Breakthrough believe there is a direct correlation between birth control and cancer, especially cancers of the breast, cervix, uterus, ovaries, and liver. Again, I know I know, it seems everything these days causes cancer. Should we stop driving, eating out, shampooing, sunscreening, cleaning our kitchen counters, using A/C, and even sitting on our couches made of foam, which I just learned is made of petroleum? It’s all so very overwhelming, and each of these and more have been studied and written about. For now, let is suffice to say that we don’t necessarily have to stop all these things, but it would behoove us to look into their ingredients and alternatives more carefully and make better-educated decisions. I’ve acknowledged that lots of things can lead to cancer; now let’s stick to birth control.

Besides potentially leading to cancer, birth control has been provably evidenced to cause heart attacks, blood clots, strokes, uterine fibroids, ectopic pregnancies, and more. This is serious stuff! Even though we hear the list of risks rattled off in the commercials and read the multi-folded piece of paper that’s tucked into our Rite-Aid bag with our new pack of pills, I know I have failed to really register the warnings. They are not without heavy, backed up merit! I don't believe in manifesting hypochondria, but speaking for myself, I feel I've been mindless in my laziness to more thoroughly understand what this thing is that I put into my body. Ignorance is bliss, and sometimes I wish I'd never read the things that I have, but even though I may never get a terminal illness from taking birth control, there's something about the entire concept that makes me uneasy, threatened even.

So, here’s my story… It’s about to get pretty personal, so be forewarned that I don’t wince from details some would describe as graphic. I do have a sense of propriety, but I believe the earthier we learn to be comfortable being, the better we are at educating ourselves and exchanging information with others. I prefer to be clear, not analogous, when it comes to health, and for me there is rarely such a thing as TMI. Especially when I can write to all of you and not have to say uncomfortable things in person and watch you fidget with embarrassment.

I have used the NuvaRing on and off for three years. It’s my hormonal BC of choice, mainly because unlike a pill I’d never remember taking daily, I only have to remember to take the ring out and put a new one in once a month. I experience no nausea, weight gain, or depression, and it actually helps to clear up my skin and even made my breasts bigger, although they’re so sore that my boyfriend can’t even play with their newfound fullness. I’m always snapping at him for the slightest accidental bump. Since I travel quite a bit and occasionally have to work all night, the ring also helps regulate my cycle, something that has, until recently, been priceless to me. Off BC, my period is affected by the minutest change in my sleep pattern or diet. I’ll go two months without getting my period, anxiously taking pregnancy tests once a week, then get it for three weeks straight. Miserable puts it lightly. Then I’ll bleed once every two weeks, for months on end, usually for a continuous seven, heavy days. This will last until I take a redeye somewhere and gone again is my period for months. Not to mention the acne breakouts, the bed-ridden cramps, the hazy fatigue, bloat, and ravenous PMS, as if the unpredictability alone doesn’t constrain my quality of life. Since I began menstruating at age 12, I have never had a regular 28-35 day cycle, which is considered average for women of child-bearing age. My life without NuvaRing is simply hellish.

Then, a little over a year ago, I got this itch. I was in San Diego for the weekend with some friends, trying to ignore it, squirming breathlessly whenever I sat, losing sleep, and excusing myself to go to the bathroom to scratch the hell out of my vag in privacy. The day before we were supposed to go home, I pulled one of my friends aside after examining myself with my eye shadow compact told her that I thought I had better see a doctor. “It’s that bad?” she asked. I nodded miserably.

I was so swollen and irritated by the time I went for help that the doctor couldn’t even fit a speculum inside me for the examination. He asked for a child’s rape kit, knowing its speculum would be smaller (*a moment of silence for the need for such things*). No child’s rape kits were to be found, so, with a female nurse chaperoning, the doctor examined me with his fingers. It hurt like hell, and he did seem sincerely sorry for having to do it. His younger male staff took care to update me on the Packers game while we waited for the results from all the tests and swabs. (Had the not-so-strange feeling that they were just hoping to get a chance to “examine” me.) Because I’d thought I had a yeast infection and had self-treated with a Monistat ovule—which had not in the least helped—my bodily fluids were cloudy and I had to wait twice as long to get clean test results. Did I mention I was also on my period this whole time?

Eight hours later I left the urgent care with a diagnosis of bacterial vaginosis (BV), a prescription for antibiotics, over-the-counter Benadryl and cortisone cream, and what was left of my pride. I was still squirming in my pants as my girlfriends and I waited for my prescription to be filled. I found that rubbing against the crotch seam of my skinny jeans in a certain way looked ridiculously inappropriate, but it brought me temporary relief. I blurted, “All I want right now is to fuck myself with a corncob.” My companions burst out laughing. I joined in a moment later, but it had been a genuine desire with no humorous intention behind it.

For nine consecutive months after that, whenever I got my period, I got the itch, and saw a new doctor almost every time. It. Was. Awful. While my only symptom was unbearable exterior itchiness (no accompanying discharge, odor, internal pain, etc.), each doctor gave me a different reason for its cause. They said it was BV, recurring yeast infections, allergies to my tampons and panty liners, hypersensitivity to my laundry detergent — even an allergic reaction to my boyfriend. I didn’t know a body could develop such a thing! That was some hard news to break to him, which fortunately ended up being untrue. STDs were blessedly never a possibility, as the nature of my symptoms was uncharacteristic and I never had one before. When I wasn’t on my period, the itching didn’t bother me, but sex became painful, my perineum was raw from the constant discharge, and the edges of my vulva cracked and bled whenever I would wipe with toilet paper. (Remember, I share this in case one of you readers has experienced the same and might benefit from my bluntness.)

Many times I brought up the possibility to my doctors that the NuvaRing might be responsible, but they all said the same thing: if it was the NuvaRing, it would irritate me while it was inside of me, not when I took it out for the week of my period. It sort of made sense, and I foolishly believed them and continued my use of it. Finally, at a wit’s end after nine wasted months, I took it upon myself to test out my theory. During my first period after I stopped using the ring, the itching was present, but a lot less intense. The second period I got was itch-free, and so was the third. Coincidence? I think most definitely not.

Even though I was off the ring, I still wanted to have sex, of course. Preferably without condoms, as I was in a monogamous, trusting relationship. Condoms bring their own kind of irritation with them, and besides, they’re just not as fun for both people involved. A few months ago, I found a gynecologist who patiently listened to my history with the NuvaRing, and she agreed that it was plausible that it had been the source of my discomfort. She gave me a free two month’s sample supply of Loestrin 24 Fe. It’s a low-dose BC that gives you 24 active pills instead of the regular 21, resulting in shorter, lighter periods. My cycle wasn’t on schedule, as usual, and I became impatient of waiting to get my period so I could start taking the pills, and took them anyway.

Halfway through my first pack, I realized I was becoming increasingly weepy over the smallest things. Everyday it seemed to be something. I cried because a dinner reservation had to be cancelled, I cried listening to Christmas music and thinking of my family, and I cried when my boyfriend told me he was running late to come home. I don't generally cry over things like this that are part of everyday life and easily coped. The BC was the only thing that was different in my life. Then, the scary part came.

I had light spotting, which I knew was considered normal. But, one evening while I was peeing, I felt something slip out of my vagina and heard a loud plop as I felt the cold splash of water on my behind. I stared incredulously at what was at the bottom of the toilet bowl. My legs started shaking. It was a fleshy clump, not in the least resembling the occasional period tissue that’s very thin, very scant, and usually very dark. I fetched a slotted spoon from my kitchen and fished the clump out, laying it against the white of my sink for examination. It was the length of my palm, and it looked like a wide, half-strip of bacon that was extra thick on one end. I wondered if it could be anything but a miscarriage. I had not even suspected I was pregnant. I instantly looked up pictures on Google of early miscarriages, and my clump did look awfully like a two-to-three week old fetus. I shook uncontrollably as I stared at it, wondering if it was supposed to have been my baby. I called a nurse hotline, and a kind lady advised me to go to the ER if I experienced hemorrhaging or any pain, and to schedule a visit with my gynecologist as soon as possible. I also stopped taking Loestrin 24 Fe immediately, as I couldn’t shake the feeling it had had something to do with it.

Long story short, it was not a miscarriage, much to my relief, nor was it a cervical polyp, which was another thing I had later considered. My gyno told me based on my description and upon uterine examination that is was most likely a decidual cast. Basically, a large, scary chunk of my uterine lining came out. She did think the Loestrin might have triggered it and offered to give me samples of something else. I asked if she thought I might try the NuvaRing once more, as I’d gone several months without it, giving it a break, and it seemed to be the only thing that had ever worked with my body. Well, until it didn’t, but I was willing to give it another try. Yes, very foolish of me. Against my better judgment and the advice of my friends, I took three samples of the NuvaRing home with me, and now, halfway through my second, I regret to say that it disagrees with my body once more. Same symptoms, I won’t repeat them.

The past week I’ve done even more research on the dangers of taking hormonal birth control, and have been desperately trying to find a reliable alternative. Here are the hormone-free options I’ve narrowed it down to (with the exception of the Mirena IUD):

• Withdrawl/Symptothermal Method. Pros: totally natural; no doctor required; low-cost (all you need to purchase is a basal body temperature thermometer; online ovulation calendars are usually free); self-educating, whether you want to avoid pregnancy or conceive; approximately 94% effective with couples who use this method correctly. Cons: very ineffective with the slightest mistake; requires complete trust in male partner’s ejaculatory self-control and female partner’s bodily awareness; lots of record keeping/calendar tracking/temperature taking; additional contraceptive must be used when the woman is in and near ovulation, or else sex isn’t safe for about a week each month while her egg can be fertilized (even though the egg itself is only fertile for about 24 hours, sperm can live for up to five days).

• Diaphragms and Cervical Caps. Pros: inexpensive; same one can be used for years; relatively easy to self-insert hours before sex, allowing some spontaneity; easy to remove. Cons: requires doctor’s visit and professional fitting to your cervix; may be felt and/or misplaced during sex; makes you prone to UTIs; can cause vaginal irritation; spermicide must be used to give adequate protection; 85% effective when used correctly and woman has not given birth (birth widens the cervix and you may need to be refitted for a new one).

• Today Sponge. Pros: inexpensive; disposable; easy to insert and remove; can be inserted hours ahead of sex, allowing some spontaneity. Cons: may cause vaginal irritation; dry sex; foul odor; 82% effective when used correctly and woman has not given birth; one-size-fits-all.

• Spermicide. Pros: inexpensive; easy to attain and use. Cons: messy during and after (women report frequent leakage); interrupts foreplay; may cause irritation to the man and woman; only 70% effective when used correctly.

• Paraguard IUD. Pros: once it’s in, you can leave it for up to 10 years; 99.9% effective; reversible; sex can be spontaneous; no need to remember to keep track of anything. Cons: expensive; must be inserted by a doctor; insertion is brief but painful (especially for women who haven’t given birth); can cause permanent damage, heavier periods, painful cramping, and sometimes can be dispelled by the body and require emergency removal.

• Mirena IUD. Pros: can be left in body for up to five years; 99.9% accurate; reversible; sex remains spontaneous; no record-keeping required; lighter, shorter periods; sometimes no period at all. Cons: expensive; must be professionally inserted, and insertion is brief but painful; can be dispelled; contains hormones, and reports of worsened skin, headaches, loss of sex drive, and other common hormonal BC reactions. I only consider the Mirena because if I go with an IUD, my gynecologist has already told me that I’m a poor candidate for Paraguard due to my anemia and already irregular, painful, and heavy periods. Mirena is not really an option for me either, because of the hormones, but I wanted to include it to show the difference between it and the Paraguard.

• Female Sterilization. Pros: permanent inability to become pregnant and/or ovulate depending on what type of surgery you choose (tubal ligation vs. hysterectomy, respectively); one-time operation in normal cases. Cons: irreversible; it can rarely result in ectopic pregnancy; expensive (costs $1,500-$6,000); tubes may be placed incorrectly, or damage may be done to the uterus during operation, requiring further surgery; recovery time is usually 2-5 days; may cause depression.

• Male Sterilization. Pros: permanent inability to impregnate; single procedure is done in less than 20 minutes under local anesthesia; men often can return to work the same day; costs $350-$1,000 which is six times cheaper than female sterilization; vasectomy by clamp (as opposed to cauterization) may be reversible if the man decides he wants to have children later. Cons: usually irreversible; can cause lasting pain or discomfort; may cause depression.

I think for most of us, sterilization is not something we want to consider. As of now, I am thinking the Withdrawl/Symptothermal Method looks best given all the considerations and my personal health history (otherwise I might go with the Paraguard IUD). I'm also in a long-term monogamous relationship with a guy I trust, and while pulling out is often ineffective by itself, I'm very disciplined and in touch with my body enough to record and interpret its changes. While this might prevent pregnancy (and that is a big, risky might), it doesn’t solve my irregular and painful menstrual cycles.

I leave you all with a few questions…

If you ARE on hormonal birth control, which one do you use, what are your experiences, and why do you continue to use it? Would you consider hormone-free alternatives, and which?

If you are sexually active and NOT on hormonal birth control, what methods do you use to avoid pregnancy? Have they been effective for you and what are their pros/cons in your experience?

Whether you are sexually active or not, if you do NOT use hormonal birth control, do you have any problems with irregular or painful periods? If so, what do you do or what would you like to try to help regulate them and alleviate pain?

I’m looking for all the insight, advice, wisdom, and learning I can get, so share away! Thank you!