Saturday, March 3, 2012

Five Things You Might Not Know About Contraception.

Contraception's been in the news lately.  Which is so weird.  I mean, it's the 21st century!  We have iPhones and robotic surgery and Roombas and Segways!  How is this even a thing?

In a sense, it's not.  The real issue is "will religious organizations be required to include free contraception in their healthcare plans?" which while still an important issue, isn't at all the same thing as "should contraception even exist?"  And yet it seems to have drawn all the creeps who want to yell "contraception shouldn't exist because SLUTS!" out of the woodwork anyway.

I don't want to expound too much on how I feel about this, because I think it's pretty obvious where I stand.  You think I'm going to spring the anti-birth-control stance on you here?  Seriously.

So instead, I'm going to expound on some relatively little-known, and hopefully useful, facts about birth control.



1. You can use regular birth control pills as an emergency contraceptive.
If you have access to birth control pills but not Plan B, you can take extra pills to prevent pregnancy after having unprotected sex.  Here's a table of the correct dosages.  This is not an abortion method and won't stop an implanted pregnancy, but it's effective for more than just the "morning after"--although sooner is better, emergency contraception can work up to five days after unprotected sex.  (It also doesn't appear to cause any birth defects, so if it doesn't work, keeping the pregnancy and having a healthy child is still an option.)

2. You're probably paying too much for condoms.
Drugstore prices are highway robbery.  (Or at least highway rubbery.)  $15 for a package of 12?  Maybe $10 for the crappy brand?  Yep, still cheaper than diapers, but you can do way better than that.

If you have a credit card and a mailing address, you can buy a giant bag of 100 for less than $19 here.  I can personally vouch for that brand being reliable and comfortable on the vagina side, and I've gotten good reports on the comfort for the penis side.  I can't vouch for these, but they're even cheaper--under $14 for 100.  At that price, you can afford to have sex and make ballon animals.

3. "Pulling out" works better than you think.
Withdrawal has a bad reputation; most people think it's more of a bad joke than a birth control method.  But actually, if it's done correctly, it works better than a sponge or a diaphragm.  Interruptusing your coitus is 96% effective over the course of a year--if you do it right.

That's the catch, though.  Pulling out is trustworthy; penises often are not.  And if you have an "oh oh OHHHHH oh shit" moment, or if there's residual sperm in the urethra, your risk of pregnancy goes up to 27% over the course of a year.  (You can remove residual sperm from your urethra by always peeing before sex and after any time you ejaculate.)  So I don't really recommend this method--except that it is by far the most effective method that requires no money, no drugs, no trips to the doctor or drugstore, no pre-planning.  All you need is your bodies (and some trust and ejaculatory control).  It's not the best birth control method, but it's the best one that you can do entirely on your own.

Note: I am not advising you to rely on withdrawal for contraception.  It is not a very good idea.  It provides no protection from STIs and 27% is not great odds. Condoms can be gotten for free or dirt cheap and they protect you from infection as well as being much more effective protection against pregnancy.

4. Spermicide is way, way, worse than you think.
The pregnancy rate (over a year) with typical use of spermicidal foam/jelly/film is 29%.  That's not great odds.  It's certainly better than nothing (85% risk), but it's worse than condoms (15% typical risk), worse than the pill (8% typical risk), worse than the rhythm method (25% typical risk), even slightly worse than pulling out!

Also, if you have a vagina, using spermicide can put your health at risk.  The most common spermicide is nonoxynol-9, which has been found to increase the risk of HIV, HPV, trichomonas, and vaginosis infections.  Sex workers are 50% more likely to contract HIV if they use nonoxynol-9.  And the reason is nasty--because it can cause ulcers to form in your vagina, which creates open wounds for infection to enter.

As pregnancy prevention, spermicide is crappy, but better than nothing; as infection prevention, spermicide is actually worse than nothing.

5. If you're on birth control pills, you don't get a period.
It certainly seems like you do, at least if you're on the 28-day-cycle kind of pill.  But the "period" you get between pill cycles is not a period at all--it's withdrawal bleeding from the change in hormone levels.  Unlike a true period, there's no uterine lining buildup and no egg in it.  It doesn't perform any cleaning or renewing function. It's just bleeding.

So why do pretty much all conventional (and the most affordable) birth control pills make you bleed every month, if it doesn't serve any purpose?  The answer pretty much comes down to "tradition."  "Normalcy."  I've heard claims it gives users "a sense of well-being," which is slightly hilarious.   Confirmation you're not pregnant--I guess that's nice-ish, but is it really worth a week's worth of cramps and stained underpants?  Ultimately, I might have to chalk this one up to "male doctors."

So calling Lybrel "the birth control where you don't have periods" isn't quite right.  Hormonal methods all stop you from getting a period.  Lybrel is really "the birth control where they don't make you bleed for no reason."

163 comments:

  1. I was once told by a doctor that I couldn't get a repeat script of the pill I was on because I reported no periods at all while I was on it, and 'I must have periods'.

    The fact that I wasn't getting periods when I wasn't on the pill apparently had no relevance.

    New doctor = nexplanon and not that worried about my lack of periods.

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    1. And yes, the first doctor was male and the latter was female

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    2. Irrelevant. The first doctor assumed there would be some uterine lining that should be shed to keep your uterus healthy. The second doctor is ok with you not having a period because she understands there is not enough lining building up. Your uterus is sensitive enough to the artificial hormones that you aren't building up a lining. This isn't the case for every woman, and not shedding the lining is a risk-factor for other health problems. No lining = no bleeding when the hormones are withdrawn.

      If you had spotting or irregular bleeding or a bleed when you stopped the pills, that would be the lining of the uterus shedding, proving it had been produced in the first place. In that case, it would be quite important for you to have a regular bleed (~every 3 months at least) to remove the uterine lining that had slowly grown.

      There is a wide range of sensitivity to the hormones in birth control. That means there's a wide range of responses.

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  2. So, about #5 -
    I know that there's no ovulation with the pill, but *something* happens over time with me on Seasonalle. I can go about 2.5-3 months before I start getting a bunch of breakthrough bleeding and it doesn't stop unless I take a week off to have a period. I have really no idea WTF is going on there, except that for whatever reasons my natural hormones appear to eventually override the fake ones.
    I would probably worry about what that means as far as contraception effectiveness goes except I'm using it for period avoidance, not birth control, so instead it's just annoying.
    Anyway. Any idea what's going on there?

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    1. I have no idea what's going on there.

      But I would guess that you're right; that it's your normal hormonal cycle breaking through. Probably the importance of the week off is not so much that you have a period but that you give your hormones time to level out.

      That's just my guess; I am not a doctor or a hormones-expert of any kind.

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    2. The same thing happens to me if I skip the placebo week on my birth control pills (Yasmin) and just keep taking the hormone pills back to back. After about 5-6 weeks I get enough breakthrough bleeding to equal a typical period for me, but it's mostly that brown oxidized-looking stuff. It was annoying enough that I just stuck with the regularly scheduled placebo week, since at least that was predictably timed. I also notice that I actually get PMS symptoms when I do that (mainly the irritability and increased cramping), which I never get taking the pill as directed or when I'm not on the pill at all and just getting my period naturally. So I would guess the hormones-evening-out thing might have some weight behind it? At least in some of us.

      The longer I've been on the pill (about 6 years now, mostly Yasmin, though recently Zovia) the more reliably I also get a bit of spotting mid-cycle (around the time one would typically ovulate), which my gyno said had something to do with normal thinning of the uterine lining over the years on the pill. I wonder if that's my body's natural hormones going "I think we're supposed to do something here! Let's try!" and instead of ovulation, that happens. Or something. I would love to know the science behind this more in depth.

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    3. I also sometimes wonder if it's connected to the fact that my body *loves* matching cycles with other women, if I'm not on the pill. The whole thing where other women's pheromones change your cycle? It's ridiculous with me. As a teenager I could never get a consistent cycle because I was bouncing back and forth between synching with my mom and my girlfriend. I swear it never mattered where in my cycle I should have been, put me next to a women on her period and I'd start mine in a couple days. SO ANNOYING.
      Hence why I've now said fuck that and just stay on artificial hormones as much as possible.

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    4. Yeah, that happens to me too. No idea why, though.

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    5. Like you, my hormonal activity is lacklustre at best when I'm on my own (I swear, my hormones are like "...meh.") but more than three days a week spent with any one woman and I'll totally sync with her.

      WEIRD... It's like "Hey! We're menses-friends!"

      Some women have particularly strong pheromone-things; they are like very giant planets and we are tiny asteroids, sucked into their menstruation-gravity. I've known a couple of women who have giant, super-massive black-hole periods, where any woman who drives past their house instantly starts menstruating. One was my boss. Occasionally, one of my friends would be stressing out because her period was late, so I'd invite them to my office. Worked every time.

      I guess it just depends on how many hormones your body considers normal, but I am still slightly in awe of women with the power to make other women start their periods. It's like a really shitty superpower.

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    6. Re: Cycle-syncing with other women. The literature is actually extremely controversial on whether or not that happens. About half the studies that look for syncing find it, and there is some pretty heavy criticism about the statistical analyses used in some of the initial studies that found an effect. Also, there is really no evidence for a mechanism that might account for the phenomenon, if it exists - pheromones are really little more than a guess at this point.

      http://www.scientificamerican.com/article.cfm?id=do-women-who-live-together-menstruate-together

      http://www.straightdope.com/columns/read/2429/does-menstrual-synchrony-really-exist

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    7. The same thing occurs to me too, usually after 2 1/2 Month. And i hate it, fake menstruations or not, I get really painful cramps.

      A friend of mine offered an explanation, though I'm not sure if it's actually true, but it sounds kind of sensible, so I might as well share it (but take it with a grain of salt).

      The pill mimics pregnancy, but of course doesn't contain the whole bunch of hormones at loose in your body when you are actually pregnant. During a real pregnancy the fetus starts producing and releasing hormones too. This is among other things a sign for the body that the fetus is alive and well, but of course this doesn't happen when you're on the pill. So after a couple of weeks your body comes to the conclusion that the fetus (that isn't actually there) isn't viable and aborts it.

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    8. @theLaplaceDemon Then I'm guessing you're either male or not one of the women with a tendency to synch. :p It's...fairly hard to argue with after experiencing it.
      Really, the problem with studying it is that all women don't have the response. The women that don't get it will lower your numbers, and if your influencing woman you're getting sweat, etc from isn't one of the ones that has a strong whatever-it-is, you won't see a damn thing.

      In other words, there's too many uncontrolled variables to make a solid study, which is exactly what leads to mixed results by official studies. Also, as I said, in my experience it's less "and now we're the same every month" and more "being around a menstruating woman brings on my period", which isn't what *any* of the standard studies have been looking for.

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    9. Also I can't seem to edit my comments, but I mean "uterus and menstruation-having people" rather than women; well aware not all women have uteri, and not all people with uteri are women.

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    10. @danaoshee

      I am a women, and have been menstruating and living with other menstruaters for some time (also, FWIW, there was a period of time--no pun intended--where I believed in syncing and thought it happened with my friends' and I).

      I agree with you that the difficulties with controlled, human research make it impossible to draw be-all-end-all conclusions from any of the studies referenced. Which is why my point was not that the phenomenon doesn't exist, but that it's controversial. Personally, I find the statistical arguments referenced in the articles I linked very compelling reasons why there may appear to be a phenomenon that isn't actually there. The human mind is good at seeing patterns that aren't real, and that in combination with the inconsistent scientific evidence for the phenomenon, and the lack of any real evidence for a mechanism, leaves me quite skeptical.

      While it is possible that such a mechanism may exist, I'm not comfortable citing it as fact and pretending that no controversy exists in the literature.

      I don't mean any of this to devalue your experience or anything like that. It is possible that, not being a women who synchronizes, I would have a very different opinion if I was in your shoes. However, from my perspective there are plenty of reasons to be skeptical of such a phenomenon existing.

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    11. Laplace, I've observed one striking example of "synching" - I came home for a visit, to the house where my mom and dad live, and despite the fact that she was menopausal and hadn't had her period for months, she started menstruating a couple of days after I did.

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    12. One striking example does not rule out coincidence.

      Again, until I see solid data and evidence of a mechanism, I'm skeptical.

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    13. danaeoshee -

      Over time, your uterine lining builds up. MUCH more slowly than if you weren't on the pill, but it does. Holly's got that point wrong.

      Eventually it can't be maintained by the pill's hormone levels, and it starts to shed irregularly (hence the spotting and old, brown blood). IF you take a week off the pills, you will get a withdrawal bleed, because without the pill hormones, nothing will be telling your uterine cells to stop making and maintaining lining. At that point, you "start over" with a slow buildup of uterine lining.

      Some women get very little to no lining, others get more. You might find having a hormone-containing IUS inserted works better for you.

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    14. Re: syncing - when I studied Biology of Women in college, it was treated as myth. There were serious problems with the methodologies of the studies that showed syncing. Basically, the most two women can be apart is 14 days and the least is 0, while the average is 7 days. One of those studies found women who live together to be off by an average of 5 days, which is not significant enough to prove any real effect. In addition, this study relied on women remembering when their periods had occurred back several months, rather than charting for several months. I wouldn't say that it can't happen, but there just isn't enough evidence to say that it's a universal thing for all women, or that when it happens it is not simply coincidence. And while anecdotal evidence doesn't count for much, I'll also add that I lived with 6 other women growing up, and I've neither experienced it, nor heard any of my sisters or my mother say that they experienced it.

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    15. I guess the course you took relied heavily on the myth of the 28 day cycle, if they figure the most 2 women can be out of synch is 14 days.

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  3. :/ Okay, normally love the posts, but I take a little issue with some of this one.

    #5: I worked in my university's health center for two semesters just educating students on sexual health topics. Most of my patients were people I spoke to just before they went to the actual medical professional to get put on the birth control they thought was best for them. Quite a few of the females I saw were freaked out at least a little bit by hormonal birth control, and a fair percentage did not like the idea of not having a period (or a "period," as the case may be - though I was taught that there is generally *some* lining being shed, as with a normal period, but not as much because of the hormones). Maybe one can lay some blame on the patriarchy for not providing proper contraception education at a younger age to combat some of the myths, like a supposed need to have a period to be healthy, but a significant number of people *do* just feel more comfortable having a regular cycle. Even with the inconvenience of it.
    #3: While you have some fair points and don't encourage it and it's better than nothing, I feel like it's almost irresponsible to list that here. Maybe it's that I'm used to working with students (and I'm still an undergrad myself, if not for much longer), a population I've been repeatedly told to Not Give the Wrong Idea. Ideally, if someone were to use this, they'd combine it with another form of protection - I'd generally say spermicide, buuuut maybe not now. It is possible to cause pregnancy with pre-ejaculate fluid, if less likely.

    But definitely like you bringing up #1 and 2. Letting people know that can also reduce any fear of emergency contraception, I think. It's really essentially a high-dose birth control pill. I've never had to use it, but I felt a lot more calm about the idea once I learned that.

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    1. #5 - Fair enough. I just hate bleeding so bad...

      #3 - I'm aware of the risk of people interpreting any percentage under 50% as "can't ever happen," but I'm hoping my readers are smarter than that? I'm trying to present this as information, not as advice to try it. But I'll add in a line about how much better condoms are.

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    2. The research I've done indicates that pulling out will work if the guy has gone pee since he's last ejaculated. Pulling out, cumming, and going right back at it is dangerous since the precum can have sperm in it. Precum is supposed to protect sperm by neutralizing the potential acidity of the penis caused by urine - and if he's peed recently he should be good.

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    3. Holly: I had the opposite statistical problem. I thought failure rates were per coitus, not per year, and thus viewed 10% as "unacceptable risk." This went hand-in-hand with Catholic teachings about damn near everything you can do in bed being sinful, and resulted in me being absolutely TERRIFIED of birth control. Even as a non-sexually-active PMDD sufferer, I wouldn't have gone on the Pill if I weren't an apostate.

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  4. Are you aware of any good deals on non-latex condoms?

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    1. It's still a lot spendier than the latex unfortunately, but here's 100 non-latex condoms for $55:
      http://www.amazon.com/Durex-Avanti-Bare--Size--100pk/dp/B004CMVZMO/ref=sr_1_60?s=hpc&ie=UTF8&qid=1330813608&sr=1-60

      Or 144 for $72:
      http://www.amazon.com/Lifestyles-Skyn-Non-Latex-Condoms-Pack/dp/B002CYXW7K/ref=sr_1_62?s=hpc&ie=UTF8&qid=1330813675&sr=1-62

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    2. You can buy Lifestyles Skyn condoms from Babeland for a dollar each. It may not be a *great* deal, but it's cheaper than most drug stores (and you're not dropping $50+ dollars at once like the super-size bucket deal requires).
      http://store.babeland.com/safe-sex-condoms/lifestyles-skyn-condom

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  5. The diaphragm is better than its reputation: for normal usage (which means ignoring it, putting it wrong etc features in the usage) it is less reliable than condoms, but in perfect usage (which is perfectly achievable and involves using it every time, putting it in right, and not taking it out too early) it is, if combined with spermicide, close to the pill in reliability. Yes, there is the issue of spermicide (though I have found that brands vary in compatibility with my insides), but on the other hand it is a very reliable non-hormonal contraceptive, for those of us who can't take hormones, and it is in one's own hands. Literally, until you try putting it in without an inserter and it shoots across the room and hides under the bookcase.
    I have a suspicion that one thing that makes hormonal contraceptives so attractive to many doctors etc is that it doesn't have an immediate connection to the sex act itself. To use a diaphragm, you have to every time make the decision that yes, you're going to have sex; if you put your diaphragm in that's a deliberate preparation for sex, happening at the point where the sex in question is imminent. Somehow I often feel that young women are not encouraged to think that way.

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    1. And there is also the cervical cap. Some don't need spermicide. They are far less fuss than diaphragms too. Some can be inserted well in advance for more spontaneity.

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    2. I don't think it's usually related to the idea that womena ren't encouraged to make a deliberate, conscious decision to have sex (though there is not enough emphasis on that in sex-education, perpetuating the role of women as passive during sex).

      More, it's a bloody hassle if you're in a long term relationship to always have to interupt foreplay in order to fit a diaphragm. You really can't have the same level of spontaneity as a woman who is using hormones or an intra-uterine device/system.

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    3. a surprising number of women don't like to touch themselves to insert a diaphragm, etc.

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  6. The real issue is "will religious organizations be required to include free contraception in their healthcare plans?"

    Not exactly. Rush Motherfucken Shittebagge Limbaugh notwithstanding, this has nothing to do with "free contraception" or "paying for other people's contraception". What it has to do with is whether contraception is considered "preventative medical care", just like all the other shit that insurance companies are required to cover in their medical insurance policies that the policy-holders pay for, whether directly or as part of their compensation for the work they do as an employee.

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    1. Yeah, where exactly did Rush get the "taxpayers paying for contraception" thing from? Am I missing something here?

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    2. theLaplaceDemon - I guess "allowing people to use the healthcare plans that they pay for to pay for contraception" doesn't sound all that infuriating.

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    3. Andrea ElizabethMarch 4, 2012 at 4:17 AM

      The Patient Prevention and Affordable Care Act (aka "Obamacare", passed in 2010) states that insurance providers cannot charge co-pays, co-insurance or deductibles (no out-of-pocket expenses) for Level A and B preventative care (not sure what that those are exactly, but I assume vaccines, etc.), with birth control being designated as preventative care. So I think the real debate *should* be (whether or not it is/was I don't actually know because following this stuff too closely depresses me) whether or not exemptions from this law violate the establishment clause.

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    4. Okay, so my question for all Americans is this: what the hell do you actually think the purpose of taxes is?

      Seriously - if it's not going to go towards your healthcare, and you're instead made to pay separately for that, what are your taxes for?

      to pay the government? The government is made up of people who are already rich (that's part of how they got there in the first place, remember?).

      I am totally in favour of the state providing healthcare. Those who have the money to pay taxes should do so - that way those who are too poor to afford to pay for private health insurance won't die from treatable illnesses just because they're poor.

      If my own government would stop starving our state healthcare, I'd be happier too. Instead they're trying to introduce an American model... Something that nobody with more brains or heart than money could possibly defend.

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    5. or you know they could just fucking not exist at all. That would be what I would prefer, and frankly I'd be willing to sponsor somebody else on my health care plan if it meant those mother fuckers could no longer write "laws"

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    6. "Okay, so my question for all Americans is this: what the hell do you actually think the purpose of taxes is? ... to pay the government? The government is made up of people who are already rich (that's part of how they got there in the first place, remember?)."

      The government is made up of more than rich Senators. There are all sorts of levels of employees.

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  7. Personally, I find confirmation I'm not pregnant WAY WAY WAY worth the inconvenience of periods. But then I don't get particularly bad cramps (in fact I frequently don't get any cramps at all).

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    1. (Obviously I meant "bleeding", not "periods". Whatever.)

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    2. except getting your period is not real confirmation that you aren't pregnant. The women in my family have a history of period like bleeding that includes cramps, bloating and emotional outbursts throughout pregnancy.

      And there are a lot of women who spot throughout pregnancy who don't realize they're pregnant until well into the second trimester. So I feel like being told by my healthcare professional that I should be having a period even *on* birth control is ridiculous.

      Granted, this is also why I opted for the three year in arm birth control Implanon, I will have spotting once every 4 to 7 months and that's it. And I can remove it at any time within the three year lifespan or choose to have a new one put in when this one is finished.

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  8. It's not as cheap as the sources Holly listed, but if you're fussy about your condom brand, "condom depot" has excellent prices and offers coupon codes regularly.

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  9. I'm not sure if this is in the category of "things people might not know", but it often escape mention. With a few exceptions, combining two or more birth control methods greatly improves the effectiveness. That seems especially worth considering in the context of some of the less reliable methods. E.g. the 27% failure rate of inconsistent withdrawal use is pretty terrible on its own, but it still roughly triples the total effectiveness when combined with something else.

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  10. Holly, have you ever heard of the fertility awareness method? It is way too often mixed up with the rhythm method, which is a terrible, outdated method. The FAM involves checking your body for signs of fertility- checking your cervical fluid daily to see the changes in consistency, taking your temperature in the morning to see when you have a thermal shift (your temp goes up after ovulation) and checking your cervix position (your cervix is highest around ovulation and lowest around mensturation- which is why certain sex positions can be uncomfortable in some times of the month and not others). I use this method and it sounds a bit fiddly but I LOVE it. I don't mind condoms but I don't see the point of using them every day of my cycle when I am only fertile for a week of it! (well actually the egg only lives for 24 hours but fertile cervical fluid keeps sperm alive for up to a week before the egg is released) So on this method I used condoms for less than half of each cycle, and that is being overly cautious. Obviously this method doesn't protect against stds so it doesn't work for everyone. But it doesn't require any prescriptions or money (after buying a thermometer). Anyway, basically I just want to spread awareness of it. I wrote a zine about FAM and menstrual cups http://www.cervixosaurus.com/zines/the-cervixosaurus-zine/ partly because a lot of my friends have no idea what their cervix feels like or what cervical fluid is, etc etc, it is a disgrace! I am really passionate about menstrual cycles, can you tell?! :)

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    1. Holly...you totally missed this method. The go-to resource is "Taking Charge of Your Fertility" by Toni Wescheler. A GREAT book for learning about the female body. I recommend you add it to your reading list.

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    2. I third this. Fertility Awareness is as much better version of the "only method you can completely do on your own" than withdrawal---just because it's the only method sanctioned by the Catholic Church doesn't make it ineffective. I've seen charts that site FAM--true FAM, NOT the rhythm method--as effective as the pill when adhered to correctly, it's just that adhering to it correctly does require a good bit of research up front and also either periodic abstinence or some form of barrier method during some parts of the menstrual cycle.

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    3. And I don't even care if the information is used for contraception, conception or whatever....it's just WAY more useful and helpful to know what is actually going on, rather than the stupid 28 day cycle myth, and the "omg, I have discharge, I must have an infection" worries, and so many other reasons why understanding better just makes a lot of sense to me.

      I wish they would use it as a basis for the biology part of the sex ed in schools. I would LOVE to put together a course on it for schools or for the many many people who could benefit. I used to do individual counseling at the pharmacies I worked at, for infertile women who were sent in "to get a thermometer" but given absolutely no other information. Many of them cried when I sat with them and explained things clearly, they were so relieved to finally have something that wasn't mysterious and made sense.

      To me, this is powerful knowledge.

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  11. Pharmacist here (and one who happily sells Plan B, or Postiner/Levonelle, as it's known in Australia) - just wanting to clarify this statement:

    "It also doesn't appear to cause any birth defects, so if it doesn't work, keeping the pregnancy and having a healthy child is still an option."

    There is an increased risk of ectopic pregnancy if you use emergency contraception - that's a serious complication, one that could be life-threatening to the patient, and means that the pregnancy most likely go ahead. This is why, if your period doesn't show up after taking EC, it's really important to follow up with the doctor.

    The risk is still small, and I don't consider it a reason not to take EC, but I think it's important to be informed. There's so much misinformation around, and I hate the way it's used punitively to discourage women from using EC.

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    1. and means that the pregnancy most likely go ahead.

      Won't go ahead. *facepalms* I accidentally a (really important) word there.

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  12. In regards to #5: I just finished listening to the newest Godless Bitches podcast (I'd recommend it to all of Holly's atheist readers), and they were discussing the reasons for the week of placebos included in birth control. Essentially, early contraceptive researcher John Rock was a strong Catholic, and he was gunning for the church's approval of hormonal birth control by arguing that it "naturally" extends the week-or-so of infertility in the menstrual cycle. In order to make it look natural, he left in the part where women need to bleed for a week. This, of course, backfired, but that decision managed to inform the development of many versions of the pill for decades.

    So yes, you can chalk that one up to "male doctors" and "religious patriarchy."
    --Jessie C.

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    1. Thank God I'm not the only person who knows this. I read the comments just to make sure someone had mentioned it.

      This is totally true. The inventor of BC pills was a Catholic and thought the church might approve it if it seemed "natural". He also thought women might like a reminder that they aren't pregnant.

      The 'false period' is allllll about the patriarchy.

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    2. I agree about this particular point, but if http://www.pbs.org/wgbh/amex/pill/peopleevents/p_rock.html (a rather admiring view) has it at all right, it sounds to me as though it was a good thing someone like him was there at the right time. Of course it's effed up that we had to worry about the Catholic church at all, but I think given the times it was necessary. Oh, heck, what am I saying, NOW it would be a good idea if we had some prominent Catholic doctors standing up against the likes of Santorum.

      Delete
  13. I just wish they'd make a fucking non-latex non-lambskin condom that wasn't fucking pre-lubricated. I'm sensitive to latex and won't use lambskin. I like the polyurethane and polyisoprene condoms really, really well, but sometimes the lube disagrees with me. I prefer just using my preferred brand.

    Also, the damn things are expensive as hell. It's really shitty, because I can't afford to use them on toys or anything like that, things I'd love to use them for, but, dude, if I did, I'd be spending more on condoms than on the drugs I need to keep me non-homicidal.

    Don't even get me started on Nonoxynol-9. That horrible shit is why when I was a teen I thought it was normal for my particular body to hurt for three days after sex. Not wanting to get knocked up, I'd never tried anything without it, and it was burning the bejeezus out of my cunt.

    ReplyDelete
    Replies
    1. Ugh. I despise nonoxynol-9. It's completely ridiculous that it's just randomly chucked into condoms and lubes without warning, considering how common allergies to it are in humans. In the wake of Holly's last post on things that ought to be taught in sex ed, this sounds like a great one. "Btw, if it hurts, try a brand without spermicide!"

      Delete
  14. Yep, still cheaper than diapers, but you can do way better than that.

    And of course they get the infantilists going and coming.

    ReplyDelete
    Replies
    1. Was that intended to be a pun? :3

      Delete
  15. Unlike a true period, there's no uterine lining buildup

    Huh, I wonder what happens to me then. Not to be gross (okay, it's probably gross, so if you don't like to think about menstruation stop reading now) but I take hormonal birth control (28-day cycle) and when I bleed, I start out with nice lumpy bits which I have always assumed are uterine lining. I will have to think about that again -- always good to have a refresher course on hormone cycles once in a while!

    Re bleeding: I have heard all sorts of things about this. When I went on the pill at age 16, it was prescribed by my pediatrician, who might not have known any better, and I was deeply relieved to have 'normal' periods -- I was taking the pill to treat polycystic ovarian syndrome, and one of my symptoms had been no menses for months followed by horrible heavy menses for many days. So it did me good to bleed pretty lightly and on a REGULAR SCHEDULE.

    I skipped over the sugar pill week once recently because I didn't want to be menstruating on a holiday. That was convenient, but I found that the next time I menstruated, I had cramps. That was possibly psychosomatic, but I still went back to bleeding every month. I kind of like it -- it still (after 11 years of being on the pill) makes me feel more like a normal woman, whether or not I am actually shedding any uterine lining -- ! but anyway, data point, some women choose to bleed.

    ReplyDelete
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    1. Holly's wrong on this point. You DO get uterine lining forming, and it DOES shed.

      re PCOS: using birth control pills does not TREAT it, it just allows for a regular, predictable, lighter uterine lining shed ("period"). You still need to deal with the insulin resistance, the risks of diabetes, heart disease, obesity, etc that occur with the syndrome. See an endocrinologist.

      Delete
    2. D, I am taking the pill to treat some of the symptoms of PCOS, which it does. I have seen an endocrinologist and a gynecologist and I am well aware of my own health needs. I made this comment to contribute to the discussion about menstruation, not as a desperate plea for someone to correct my ignorance about my own body. I didn't expect to be patronized with medical information that is both incorrect and unnecessary, not to mention condescending. Please don't trouble yourself to reply to this.

      Delete
    3. no, I will, thanks. FYI I have PCOS, and am certainly well aware of the hormonal and health consequences.

      What part of what I wrote do you believe is incorrect?

      Your saying taking BCP treats PCOS is incorrect. Saying they address a SYMPTOM of it is accurate. Your curiosity about what "was happening to you" during your withdrawal bleed reveals you don't know quite as much as you insist...

      I'm glad you are doing the right things for your situation. Many doctors still view BCP as a treatment, do nothing else, and do not educate PCOS patients well at all. They never mention the other risks and factors, such as insulin resistance, endometrial hypoplasia, heart disease, high blood pressure, etc that very often go along with PCOS.

      If your doctors have never mentioned these risks....you aren't being fully educated on the syndrome.

      Delete
    4. D, I'm going to need you to either give your professional/educational credentials or cite a source here.

      Because you're coming in here like the only person on Earth who knows what a uterus is and being very condescending with all the commenters, and unless you're actually an endocrinologist or similar yourself, or you've got a very recent scientific source open in front of you, you need to be a little less sure of yourself here.

      Delete
    5. What source would you like? PubMed papers? For what specifically? I am happy to provide whatever would make you feel better about the information.

      (No one is citing any sort of source for their MISinformation, so perhaps some of that should be requested as well. It would be interesting to see how people back up their ideas.)

      I don't mean to be condescending, but the level of misinformation is frustrating.

      I am a biologist with a special interest in human reproduction/infertility.

      Delete
    6. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001408/

      here, March 2010. re PCOS.

      Delete
    7. without knowing what you want me to source for, I'm just giving a basic reference. Am happy to find references for anything anyone wants, or take correction via similar level of sources.

      Delete
    8. Okay, thanks, that actually makes a big difference.

      I have PCOS too, I take BC pills for it too, and I'm aware it doesn't treat all potential symptoms, but in my case I have normal blood sugar and pressure so (at least according to my doctor) there wasn't much else I needed.

      Delete
    9. Metformin has sort of become the PCOS standby to deal with the insulin resistance that can cause some of the hormone wackiness and physical issues. I tried it, it helped some, but I have a variant of PCOS that doesn't respond as well as the "regular" kind to metformin. Which kind of sucked because it is inexpensive and can be quite helpful.

      Normal blood sugar is a tricky thing. A lot of times, drs have a look to see that values fall within the "normal range" that the lab they use prints on the results but don't consider the relationship between the different things, in my experience. Sometimes (like with the whole LH/FSH ratio) normal depends on a lot of factors, and has to be normal relative to other values...does that make sense? I'd have to look up the reference value, but it's the ratio between fasting blood sugar and fasting insulin level that will give a better idea if you have insulin resistance.

      From years of dealing with PCOS issues and talking to others who are doing the same, I have come to realise that women (and men, it's called Metabolic Syndrome X, since they can't blame men's ovaries ; )) often chose to deal with the syndrome at different levels. My own level of involvement and interest with it has waxed and waned over the years, for various reasons. The idea that it's just ovaries involved has always bothered me though.

      Delete
  16. You mention risks of pregnancy for various things. Is that the risk of pregnancy for that act under whatever circumstances, or comparative to pregnancy risk for unprotected sex? what is the risk of pregnancy for unprotected sex way?

    ReplyDelete
    Replies
    1. That's total risk of pregnancy, over a year of sex. (Not per act, and not relative to unprotected sex.)

      The risk of pregnancy for unprotected sex is about 85% over a year, although obviously that varies with age.

      Delete
    2. When you say "a year of sex"... obviously frequency of sex is going to affect pregnancy risk, so how frequent is the sex assumed to be in this "year of sex" we're using for our statistics?

      Delete
    3. However often the people in the study decided to get together, afaik.

      Delete
  17. I didn't know hormonal birth control actually stops you from getting a period. That makes it even more ridiculous that for some reason my period is coming in the last week of my hormone pills, a full week before I even start the placebos. I'm gonna talk to my gyno about that.

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    1. It doesn't necessarily stop a monthly bleed. It just is somewhat different to a period that happens if you ovulate. Regardless of the hormonal details of what happens, if your uterus grows any lining at all, at some point it MUST be shed, and you will get vaginal bleeding (aka, in common terms, a period)

      Talk to your gyno, but it is not reasonable to assume that hormonal birth control will stop you from bleeding. There are a few that might work better than the one you are one, for having more predictable bleeding, but if you are expecting the pill to stop your period, you're gonna be disappointed.

      Delete
  18. I am with you on blaming the patriarchy for misinformation and pressure into normalcy with respect to bleeding while on the pill, but please stop enforcing the idea that having your period has to be a horrible thing.

    I love having my period, there are no cramps, just a feeling like having a tiny massage inside my body which I enjoy, and I am feeling much more vibrant while menstruating. I really love the feeling of everything flowing, and it also makes me feel quite powerful (which may be because I don't use anything like tampons or sanitary pads or cups - I don't menstruate very much liquid, so changing underwear and trousers works pretty well for me in the age of washing machines).

    I know that a lot of people feel different on this, but I know a lot of people feeling like me as well, and frankly I believe that the "common knowledge" that menstruating has(!) to be painful is rooted in the patriarchy as well.

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    1. I suffer from PMDD and I still have nothing against menstruating or the faux-period I get. For me, it seems like a miracle: I'm having a period, but I can still stand upright for more than 15 minutes! The cramping is actually bearable, even without aspirin!

      Delete
    2. I'm really legitimately surprised that it's possible to not use pads or anything to catch the blood. I'm guessing if you bleed a tiny amount and wear dark coloured trousers, maybe? But even with a pad on I have in the past managed to bleed right through onto furniture and things, which is really embarrassing and a pain to get out. And getting bloodstains out of clothes/bedsheets is also a real pain if it's been there for any length of time.

      Don't get me wrong, I don't have a problem with having my period at all and as I get very little cramping (nothing that can't be sorted with over the counter painkillers, and usually only for the first day) and do like feeling that my reproductive system is functioning and resetting itself, it's a nice feeling. Then there's the security of not being pregnant, which is always reassuring, and the feeling of wanting to look after myself a bit more than usual. I'm sure people reading this are going to think 'oh she doesn't know she's born with those easy periods', but I've had horrible problems in the past with low iron levels on my period that sometimes led to nausea, vomiting, dizziness and faintness etc. Luckily I've found a way of managing it with supplements and high iron veggies, and despite those problems I still don't mind having my period. I'm not sure I'd be very keen on going on the pill now that I know it stops your periods and makes you bleed in a different way (which is just a very weird idea ^^). Maybe people who get really horrible cramps feel differently though.

      Delete
    3. Holy crap, you don't have to use pads or anything? No wonder you don't mind!

      My period is physically painful plus messy as hell; nobody had to condition me to not enjoy that.

      Delete
    4. Another person here not conditioned into disliking bleeding from my genitals for days out of every month.

      Now, the idea that they're "gross" or "nasty" is conditioned, and I find it boringly common among my friends.

      I no longer subscribe to the idea that there's something embarassing or awkward about periods - they're totally natural and should never be treated as shameful.

      I used to regard my periods as a nuisance, but thanks to investing in a Mooncup I no longer have that problem either, I don't have to worry about leakage (as with pads) and I don't get sucked dry (as with tampons). But I still wouldn't say I enjoy my periods!

      Delete
    5. I bleed heavily and get cramps so bad that I literally have trouble standing up for the first day. I bloat and break out; I'm exhausted and sore and irritable. My period SUCKS. If I never had to deal with it again, I would be very happy.

      Your period doesn't suck; that's great for you. I'm not even being sarcastic there. But the idea that every woman who doesn't view her period as a magical gift from the moon goddess has been conditioned to hate it is frankly annoying as fuck.

      Delete
    6. and some of us end up on vicodin for a week and still get no relief. I'm sick and tired of this natural woman ra ra ra nonsense that has pervaded feminist spaces recently. For some of us periods are seriously THE WORST FUCKING THING. You have ten thousand different pills that you can take and still enjoy your magical moon time. The rest of us would like to be able to talk about why our periods suck without your "it's all a made up myth of the patriarchy" bullshit.

      Delete
    7. You know what's funny? In school I was told that periods would suck far LESS than mine actually do (well, did. Now I have a mirena IUD and hardly get periods at all). That stupid little pamphlet said I would probably only bleed for 3 to 5 days, and might, *might* need to take the odd painkiller if my cramps were especially bad. Lies! Filthy goddamn lies! I used to bleed for at *least* 7 days straight, needed to take painkillers most days of my period because I got horrible cramps (the sad thing is I feel comparatively lucky that I only occasionally had to leave class due to the pain), and got the delightful added bonus of constipation and diarrhea during my period. Yes, both of them. They alternated at random with very little warning.

      So no, nobody brainwashed me into thinking that my period sucks.

      What is patriarchal brainwashing is the idea that it's so normal for menstruation to be a miserable experience that it's not worth treating, that cramps are all in women's heads, and that simply having a period is so embarrassing that it's not worth bringing up any issues with your doctor. I don't find my period itself embarrassing (although I really don't enjoy bleeding through my clothes), it's just painful and inconvenient and I'd really rather not.

      Delete
    8. Menstruation liker from above here: Could you please stop diagnosing why I enjoy my period via the internet and lashing out on me about that I want to trick you into liking your period and stop fantasizing about me as a natural woman and moons and stuff and just read what I said?

      I said that I don't like my and others experience of periods being nice to be ignored, just like you don't like yours to be ignored. And I didn't say that your cramps and other discomforts are invented by the patriarchy, I said that the cultural belief that menstruation is always (!!!) horrible is rooted in patriarchy in my opinion. Hence the exclamation mark in the last sentence in my original post...trying it with three of them this time in the hope of people actually reading my post instead of insulting me *rolleyes*

      And whatever, could you just try to be decent human beings and not speak to me in this way?

      Delete
    9. I should clarify (since some people seem to be eager to project the worst of intentions on other people) that by "the cultural belief that menstruation is always (!!!) horrible is rooted in patriarchy" I DONT mean that you wouldn't have cramps if you were feminist or liberated enough or stuff. By "always" I mean "for every person" or "for every person every time".

      Delete
    10. Anon--

      I don't think anyone is trying to diagnose why you like your period, but the tone of your initial comment came across as incredibly dismissive to me, and evidently to more than one other person here.

      Holly never said 'having your period is a horrible thing.' She said that the whole notion that of course women ought to have their period because TRADITION is stupid.

      Delete
    11. I'm with Anonymous. Just because some of us have horrible periods, doesn't mean everyone has horrible periods every month, and we shouldn't give kids that idea, or we could create a whole generation of neurotic women!

      Hel, even MY period didn't always suck. When I was a teenager, the worst that happened to me was stained clothes (I had a roughly 35-day cycle, and often misjudged the start day). As time went by, I started getting mild cramps, then started feeling tired a little more easily, and after roughly 9 years of menstruating, it had progressed to the point of being absolutely horrible. It was a gradual progression, and didn't become more than a minor hassle at laundry time until I was in my early twenties.

      @Aebhel: Horrible cramps? Trouble standing up? Exhausted all day? That sounds like the exact symptoms I had. You may have PMDD--talk to your gynecologist to find out for sure. When it's that bad, treatment is generally a good idea.

      Delete
    12. @Anon

      "I said that the cultural belief that menstruation is always (!!!) horrible is rooted in patriarchy in my opinion."

      I kind of think I can see what you're getting at. It sounds to me like you're saying the process of menstruation isn't in and of itself horrible *if* you are lucky enough not to have painful cramps and inconvenient heavy bleeding. I even agree with that. If my period didn't involve intense pain and inconvenience, I really wouldn't mind it.

      However, I think the cultural belief that having a period sucks may not be rooted so much in a patriarchal dislike of women's bodies as in the fact that the majority of women (or at least the majority of women commenting here) do in fact have miserable periods.

      What I wish I had learned much earlier in my life is that while it's not unusual for having a period to suck, there are lots of treatments out there and you don't have to suffer.

      Delete
  19. Putting my hand up as someone who hates periods and finds them a waste of time. I get quite severe cramps, headaches and have to wear maternity pads or I soak through them in about an hour. If wanting to get rid of that and talking about wanting to get rid of it makes me a bad feminist in league with the patriarchy, feminism isn't what I thought it was meant to be.

    ReplyDelete
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    1. Try a diva cup.

      Delete
    2. I think I'd be okay with the whole "but some women really do want a period" thing if it were presented as an option. If it was standard procedure for doctors to ask when prescribing birth control, "do you still want to bleed?"

      But (at least in my experience) standard procedure is to assume every woman wants a 28-day cycle unless she specifically pushes for Seasonale/ique or Lybrel. That's the patriarchal part--assuming women would rather do what's "natural" than actually asking them.

      Delete
    3. When it gets right down to it...what is natural is NOT bleeding every month. Natural is being pregnant and/or lactating for most of your reproductive years, with 2-3 yrs between ovulations, assuming your ovulations are suppressed during lactation. There would also be no uterine lining created under those conditions, and therefore no need to have it removed via a period or a birth.

      I'm guessing no one here really wants to "go natural". In that case, the limitations of hormonal birth control have to be considered....not all women will be able to go without bleeding, and the lining of the uterus must not be allowed to build up, even if it forms more slowly than it otherwise would.

      Even Seasonelle is supposed to be taken in a way that produces a withdrawal bleed every 3 months/4x a year. Lybrel manufacturer information clearly states "When prescribing LYBREL, the convenience of having no scheduled menstrual bleeding should be weighed against the inconvenience of unscheduled bleeding and spotting", and the manufacturer information also shows that after a year, the number of women who are period-free is approximately 65%, with some 40% reporting bleeding and/or spotting.
      http://labeling.pfizer.com/showlabeling.aspx?id=489

      Feminism shouldn't mean misinformation in the opposite direction.

      Delete
  20. I am a very happy customer of a copper IUD. The pill either made me weepy, or it suppressed my libido (I tried at least four different ones).

    A tip here is the nurse-midwife who claimed to be really good at installing IUDs really was much better at it than the doctor. If the practitioner is skilled, they can install one without clamping the thingie onto the cervix, which is the only part that hurts. I think it's well worth asking around for a practitioner who is all "I am the queen of UID's!"

    The midwifery practice I go to is happy to dispense birth control and do well-woman checkups, and they are better at it (as in, gentler with the speculum, nicer) than many of the nurse practitioners I've had when going to an internal medicine group practice. (The OB who did my first IUD was clumsy, complained to no end about the size and placement of my uterus, and then sent me out for a CYA ultrasound.)

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    1. I've used a copper IUD since 2008 and it has been much better for me than the pill which made me flatline emotionally and killed my libido. It took some time for me to realize that the pill was causing the symptoms, but luckily my doctor was very supportive of me getting an IUD (no nonsense about it being only for people who have given birth).

      Never knew that nurse-midwives are allowed to insert them. When I move to a location with better services (currently in the Canadian Arctic), I will definitely try to find a midwifery practice for my well-women checkup needs.

      Delete
    2. I don't think it's true that clamping the cervix is the only part that hurts. In my experience, it was the insertion itself that hurt. (I've had one insertion within a year after childbirth that didn't hurt at all, and a subsequent insertion many years later that unexpectedly hurt quite a lot. However, the first one was followed by fairly bad cramps and much lengthier periods for the first couple of cycles -- this was the non-hormonal IUD -- and the second was not.) Apparently some practitioners will numb the cervix before insertion, which sounds like a really good idea if you've never had a baby.

      Delete
    3. To tell more of the story, when I had an OB do a IUD placement, she poked my uterus with a sound (small twinges), complained about how small my uterus was, then clamped something to my cervix, and after that, every time she touched anything, I got a nasty crampy pain. Not awful (and I've had menstrual cramps that were worse) but it did hurt, and when it was done, it hurt (much like mild menstrual cramps) for an hour or two afterwards. It wasn't a bad bargain overall. Since it was after the birth of my first child, I don't think the "your uterus is small" was real, just a blame-the-patient thing.

      When the midwife did it, I felt one small twinge, and was surprised that that was "all done" since I was expecting that as the initial poking around. I asked why, and she looked very pleased and told me (and the other midwife in the room) something along the lines of "the secret is not to use the [clampy thing] if you don't touch the cervix it doesn't hurt."

      I think it really is one of those things where skill, practice and dexterity make a huge difference. (I am comfortable enough with my body, that if the trainee needs a turn to do something, I'm often happy to let them. However, I've never seen any practitioner complain about the size of my anything, or my retroverted uterus, and then go on to show competence. This goes double for phlebotomists.)

      If you're on this path, I would suggest shopping for a provider who is confident and takes pride in doing them well (phone a group practice and ask "do you have someone who is really good with IUD's?") rather than one who needs to numb the patient's cervix routinely.

      Oh, and I had to go back to have the strings trimmed, since my husband said they chafed him. That was no biggie, either time.

      Delete
  21. you are just plain wrong that there is no uterine lining build up on the pill. SOME women do not build up enough to bleed, and some types of pills prevent much buildup, but if you bleed it's your uterine lining shedding. It forms. Even that link you provided says "the change in hormone dosage causes the uterine lining to weaken just enough to allow for some bleeding to occur."

    Saying it's not a period is accurate, but confuses the heck out of 99% of women who don't understand that there are more than one type of bleeding, and that "a period" is an imperfect term. What you MEAN is that usually a bleed happens when an egg remains unfertilised and does not pick up where the corpus luteum leaves off, 14-16 days post-ovulation (pretty much always...no matter HOW long your cycles...the variation is in the first stage of the cycle)

    The lining needs hormonal support, either from pills, the corpus luteum, or a fertilised egg implanting and sending signals to the corpus luteum until the placenta takes over. No hormonal support (placebo pills, no corpus luteum, no fertilised egg), and the lining sheds.

    Since the pill prevents ovulation, there IS no corpus luteum, and no egg. Therefore, the bleeding is caused by removing the pill's hormonal support....withdrawing the hormones. Hence a withdrawal bleed, and not a post-ovulatory bleed. Different mechanism.

    I AM pretty much an expert on hormones, and there's a fair bit in this post that is factually cringe-worthy. :(

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    1. Since the pill prevents ovulation, there IS no corpus luteum, and no egg. Therefore, the bleeding is caused by removing the pill's hormonal support....withdrawing the hormones. Hence a withdrawal bleed, and not a post-ovulatory bleed. Different mechanism.
      That's what I said! I don't understand what I was wrong about here. :(

      Delete
    2. No. You said there was NO uterine lining buildup. There is. And it sheds. The shedding is triggered by the withdrawal of the pill hormones, and not the collapse of the corpus luteum. That's the main difference. The amount of lining that grows with pill hormones may be different to the amount that would grow without the pill, and for many women there is less lining produced (depending on the woman, and the pill)

      Delete
    3. Okay, I will do more research and check about this.

      I maintain it's still not really a period, though.

      Delete
    4. I'm not arguing that point with you. But you are wrong about the lining. And it's freaking out the women that get withdrawal bleeding because for most women, any sort of regular bleeding from the vagina is a period. Saying they don't get a period, and don't get uterine lining is confusing (and wrong re the lining....where do YOU think the blood comes from? It's uterine lining, not actually blood, if you want to get really accurate...)

      It is actually called "non-ovulatory" bleeding, if there is no egg. In the case of pills, it is also called, as you said "withdrawal bleeding" if it happens when the pill hormones are stopped.

      Definitely do more research. I know of what I speak, and you need to do a bit more reading up.

      Delete
  22. About the pill making us bleed regularly only for tradition: I have had both a gynecologist that I visited (male) and a friend of mine who is a doctor (female) say that not bleeding at least every 6 weeks increases your chances of uterine cancer. So... there's that.

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    1. I think it can be a little less often than that (~ every 3 months) but YES to this....with the caveat that there has to be lining developing. SOME women are suppressed enough by the hormones not to build up a lining...but if you DO bleed or spot at all, you ARE growing uterine lining and you MUST clear it out regularly because it DOES increase the risk of uterine cancer.

      Saying it is only for tradition, or only to prove non-pregnancy, or only to please the male medical world, or any other such silliness is ignoring a true health issue. And freaking out the women who now wonder if their monthly bleed is a sign of problems with their birth control pill.

      Delete
  23. Any recommendations for non-lubricated condoms? I'm allergic to glycerin.

    ReplyDelete
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    1. Under $14 for 100 here:
      http://www.amazon.com/Natural-Feeling-Condoms-Non-Lubricated-Condom/dp/B000ANKXP4/ref=sr_1_2?s=hpc&ie=UTF8&qid=1330899015&sr=1-2

      Delete
  24. Could you clarify the pregnancy risk rate in the withdrawal section by adding "in a year" to "27%"? The Planned Parenthood site says, "Of every 100 women whose partners use withdrawal, 27 will become pregnant each year if they don't always do it correctly." What you wrote makes it sound like one screw-up during one sexual encounter = a 27% risk of pregnancy occurring from that encounter: "And if you have an "oh oh OHHHHH oh shit" moment, or if there's residual sperm in the urethra, your risk of pregnancy goes up to 27%."
    Also, yes, the withdrawal bleeding is the uterine lining that builds up while the pill hormone levels are constant. It is the same stuff as during a "true period," but it is not a "true period," only because ovulation has not occurred and the uterus hasn't gone,"awww, I'm not pregnant; I guess I better make things inconvenient and/or a living hell.*"
    *Scientific fact.

    ReplyDelete
  25. http://www.ncbi.nlm.nih.gov/pubmed/20851230

    Endometrial safety of a novel monophasic combined oral contraceptive containing 0.02 mg ethinylestradiol and 2 mg chlormadinone acetate administered in a 24/4-day regimen over six cycles.

    In there you will find the 76% figure for secretory transformation or suppression of endometrial proliferation, after 6 cycles.

    That is the mechanism that causes reduction of "uterine lining" volume over time when taking OCP. Basically, the level to which that occurs in an individual will determine how much/if they bleed, because it determines how much/if the endometrial tissue functions.

    ReplyDelete
  26. holly, is there anyway to know what type of lube crown uses on their condoms? The lube that some condom brands use contain an ingredient that I am allergic to. I'm actually looking for a different brand of condoms anyway (because my brand changed their packaging and it sucks) so paying that much less for them would be a wonderful change.
    Also I'm pretty pissed to know that there has been a pill on the market for five years that stops your period and not one of the 30 gynecologists I've seen who all say that I need to not have a period (endometriosis and allen masters syndrome FTW) has prescribed it to me.

    ReplyDelete
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    1. I don't know what kind Crown uses. :( They definitely are pre-lubricated with some sort of Mystery Juice.

      But here's some cheap non-lubricated condoms, at under $14 for 100:
      http://www.amazon.com/Natural-Feeling-Condoms-Non-Lubricated-Condom/dp/B000ANKXP4/ref=sr_1_2?s=hpc&ie=UTF8&qid=1330899015&sr=1-2

      Delete
  27. I don't use the Pill because I dislike it. It feels unnatural and I don't quite feel like myself on it. It messes with my libido. I use condoms and they've been working out so far so good for me the last 3 years of a serious relationship.

    I also get annoyed at how people are "grossed out" by periods. I use re-usable pads (LundaPads) and the reactions people give when I tell them that are ridiculous. They're like "EWW you have to WASH them??" I honestly don't find it gross...I find using tampons *way* more gross. Perhaps because I always had a heavy period from the time I was a teen and was always washing out my underwear, sheets and pants anyway....but seriously it's not bad at all, it saves a ton of money, it's way more comfortable to me and it's environmentally friendly.

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    1. Question: They don't feel like those horrible disposable pads, do they? I switched to tampons because I didn't like that horrible slimy, sweaty feel, or the way they felt like a diaper.

      I might switch to washable pads if they really are more comfortable. (I've tried cup-type stuff, but apparently you can't get those in right unless you either have a REALLY short vagina or are able to fist--I've never been able to get one in properly.)

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    2. I also get annoyed at how people are "grossed out" by periods.

      ...Because coming into contact with thick, hot, chunky blood is actually awesome and fun?

      I don't really get the deep horror some guys feel toward menstrual blood, and I'm not appalled by the idea of reuseable menstrual products, but come on. Having viscera trickle (or in some cases pour) uncontrollably out of your body is gross.

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    3. Question: They don't feel like those horrible disposable pads, do they? I switched to tampons because I didn't like that horrible slimy, sweaty feel, or the way they felt like a diaper

      ... sometimes I feel like I'm the only girl on the Internet who loves disposable pads. So frikkin' convenient! It would take a global apocalypse to ever get me to switch.

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    4. Laura - they feel nothing like disposable pads, and don't have the nasty chemical smell either. And re the cup, no, you don't have to be able to fist nor have a very short vagina. You may need to try a different style of cup or different method. Cups are awesome. cups and cloth pads (I make my own, cuz the bought ones are expensive, imo...but they DO last for a very long time and are cheaper than disposable)...very awesome.

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    5. Ah. If it helps...the brand I tried was a disposable cup called "Instead." Because it didn't come with any kind of applicator, I would have basically had to shove most of my hand up there to get it into position around my cervix. I was still a virgin at the time, and had never ventured the area with anything larger than a tampon. My lady-parts were having NONE OF IT.

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    6. I've tried Instead and it was the WORST thing ever! For me anyway. It wouldn't stay put and it didn't fit comfortably. My diva cup, on the other hand, is my favorite thing ever for periods. You don't have to be able to get it that close to your cervix, as it's meant to actually sit a little lower in the vagina and just form a seal. You just have to be careful that your cervix isn't outside the ring, if your cup is even that far up there (which it is for me since I have a short vagina and the diva cup is one of the larger brands of reusable menstrual cups out there). But as far as putting it in goes, it folds up about the size of a tampon applicator for insertion. Takes a little practice, but I find it very comfortable (much better than tampons). The only problem I have is sometimes the seal breaks when I'm sleeping or doing yoga poses that are a bit on the pretzely side, which may just mean I should switch to a smaller brand, like the moon cup. I can also vouch for the non-diapery feel of cloth pads, which I mostly use as a panty liner with the diva cup, or for overnight use. I save soooooo much money in the long run too.

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    7. So it's not that I have the wrong-shaped parts, it's that Instead, in particular, sucks ass at staying folded-up? Duly noted. I'll have to look into Divacup--that, combined with 1 or 2 homemade pads, should last me a good while

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    8. well....the instead isn't supposed to say folded-up...

      I liked it because I could have sex wearing Instead during my period when I didn't have a guy who could handle it.

      I have a Diva and like it just fine. I have about 8 cloth pads, but once you get the diva (or mooncup or whatever) sorted out, you don't need many per period. It's great for heavy cycles because it holds a lot more than any tampon or pad, and for light cycles you can wear it all day without emptying it, so you don't have to fuss at work or whatever. (Not that I fuss, just remove, empty into toilet, replace, carry on)

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    9. My mother made my first reusable pads when I was 11 and got my period, and over the years I just keep making my own. Certainly, this requires some skill at sewing, but not much, and any soft cotton scraps work great. I have about ten of them, and they go into the laundry with the rest of my clothing. The Bearded One who shares laundry duty with me doesn't mind. They're comfortable, work well, and are environmentally friendly. Certainly not for everyone, but they work really well for me.

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    10. @Anon: I couldn't get it to stay folded long enough to get into place at all. The only way to hold it shut for insertion was to pinch the middle of it, and I couldn't pinch and reach that far up myself at the same time.

      My problem with Instead wasn't leaks or anything else. It was the fact that I could not get it into position at all.

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  28. Seconding (thirding? I've lost count) the advice about scheduling a withdrawal bleed at least every 3 months. My female doc suggested I skip every other "period" if I wanted to, but that I could go as long as 3 months (swimsuit season!) provided I didn't mind rather heavy bleed afterwards.

    And GOD how I love the Pill for making my cycle regular to the frikkin' HOUR. SO much better than my "natural" 28-35-whenever-the-damned-uterus-feels-like-it cycle. Not to mention the clear skin and lack of cramps. Keep the hormones coming, medical science!

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  29. long time reader, first time poster.

    i have PCOS. i had it so bad that i had the same amount of testosterone as a normal man. having "gone through puberty twice" was not fun. so i take serveral pills, including birth control. if i was to go off of these pills, i'd turn into a PMS/angry teenage male monster.

    what makes me angry is that these people (mostly celebet men) think that women are stuck in the virgin/(mother, but only under their definision of marrage)/whore complex. a woman who uses birth control (of whatever flavor) is her choice and should be covered by health care. sexual health is important and needs to be addressed.

    i know what it's like to work for a company that wouldn't cover the pill, even when i filed under the company's exception clause. however, they would allow for ED pills, which was a total double standard...

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    1. I think the politicians either don't know or don't care that the Pill has uses other than preventing babies.

      Considering that my father was all for the so-called "conscience exemption" while both his wife and daughter are taking BCPs, I'm leaning toward "don't care."

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  30. I still remember coughing up a few hundred dollars for damned BC back when I was uninsured. The doc held it hostage unless I submitted to a rectal exam--something I had not been informed I needed when making the appointment. Because dammit, doctors simply will not believe you when you say you have never had PIV or PIA sex. (I was getting the damn pills for hormonal issues.)

    You know what's fun when you're a rape survivor? Finding yourself flat on your back on an uncomfortable surface, half-naked, with some stranger stuffing things into you, for no medical reason but because you're uninsured you have to do it or have wasted a bunch of money. And you have to fucking RELAX too or they have to do it again.

    The punchline? I spent hundreds of dollars and had a meltdown for nothing. It only made the hormonal issues worse.

    And that's why I haven't gone to an OB/GYN in over two years. Fuck that shit; I'll cheerfully accept the risk that I might have cervical cancer (in my mid-twenties with no family history) if it means I don't have to put up with that kinda bullshit ever again.

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    1. It's depressing what so-called 'doctors' think they are Entitled to get away with. Misguided, Entitlement and greediness and not being caught/punished... seems to make these things worse, doesn't it? Maybe they think that it's ok, because no one has complained overmuch before? I hate it when ppl think it's ok to get away with something just because it is so easy to get away with it. The probability of 'getting into trouble' shouldn't be the only thing someone thinks about before deciding to take advantage of another person's position, whether it be by withholding something or by having more physical strength.

      This kind of sexual harassment/assault/abuse is a disgusting violation-feeling, and I am sorry you had to go through it. I would definitely say it was at least 'abuse'... I don't see why she/he would need a rectal exam, although I could be wrong. I would definitely be very upset if I was coerced into it for MY hard-earned money... I don't usually have a problem w/ ppl, but I could def find some anger in me when dealing with ppl like that. I guess smugness and abuse of power/position is just a pet peeve of mine.

      (My alcoholic mom abused her 'role' of being mother to get what she wanted from my dad many times, until he finally couldn't live that way anymore and thankfully got her out of our house, finally. I am ok with talking to her still, but don't expect her to change any time soon.)

      Even though it might not sound that bad to some, because it was a 'medical' thing done by a 'doctor'... I think that actually makes it worse... Because you are SUPPOSED to be able to trust them, and they have abused that trust. They were probably not affected by it at all, but you will have to live with the memory :(

      The whole terrible thing about the predator and the prey... The prey is victimized and the predator is in charge and gets whatever they want, without caring about you. It can be a fun roleplay in the bedroom, but it is NOT a fun thing to do or have done to you if it is not Consensual (assuming one enjoys it when their 'partner' is enjoying it... overall... my 'roleplay' can get kinda intense even when it's physically tame, so my partner and I have to be more attentive about each other, and know that line between 'enjoying' and 'not enjoying'... especially if the guy is uncomfortable with doing certain things to me, and I have to respect his limits as well :)

      When I first got BCPs (hoping to help with my horrible horrible period symptoms and not intending to actually start having sex *just* yet, as I personally wasn't ready for it) my aunt took me and it wasn't as bad as I was sure it was going to be, even though I had hoped it was going to be a woman doing it, so I was lucky for that.

      If my aunt had taken me to him and I was told (in the middle of it) that a rectal exam was necessary because he 'had to be sure I wasn't having sex'... well, that would have hurt my trust in both her and the 'doctor'... that's something I would really needed to know going into it, so I could find a different doctor. One that I could actually work with, not one that would not trust my answers, and vice versa... >.<
      IMO, if a doctor thinks a patient is lying to them, it is better to let them know that they can't properly treat you if you aren't honest, rather than going in and getting evidence to catch your lie... Am I just crazy that way?
      The military always threw BCPs at me as long as I had an up to date 'Well-Women's exam'... so my future experiences with civilan doctors may be different (which I will be trying, since the VA has kinda been disappointing).

      I was quite young then and I don't trust people very easily sometimes, so I realize now that her way of going about it (trying to gain my confidence) really put me off (pushed me away).

      -Blueberry

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  31. Over the course of 10 years (14-24) I was on just about every kind of common BC pill there was (Marvelon, TriCyclin, Allesse, Something that started with an N, plus the Patch), and they all made me a miserable bitch. Obviously, the raging hormones of being a teenager/early 20's assisted, but I was So Much Nicer when I went off the pill.

    After quitting the pill, it took nine months for my period to show back up, and then another year or so to normalize and start on a perfectly regular 35-day cycle. Not 28, but hey, at least it was regular.

    My husband and I used nothing but the pull-out/rhythm/timing the calendar method for a year, and while I did end up pregnant, it was right around the night we were drunk and forgot to pull out. Last a year on nothing but timing it? Decent odds. For a financially stable adult in a long-term happy relationship, anyways.

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    1. It doesn't have to be 28. or ANY number. Or even all that regular.

      The only part of the cycle that is pretty consistent between periods and across women is the 14-16 days between ovulation and menstruation. So consistent that if you go more than 18 days (which you know if you chart your temperature), you are pretty surely pregnant. And if you go less than 12 days between ovulation and menstruation, you have luteal phase deficiency.

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  32. I love withdrawal. Or rather, I love that withdrawal allows my partner to take an active part in pregnancy prevention, and I love that this makes him feel secure and happy.

    My birth control pills (progesterone only) prevent me from bleeding. I take pregnancy tests about every month to confirm that I'm not pregnant, but using two methods makes me feel pretty secure.

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  33. The shot, y'all. I cannot recommend it enough - if the hormones in BC don't mess with you, that is. I don't have to remember to take a pill every day (1 appointment on a calendar every three months is a lot less likely to be forgotten) and NO PERIODS/BLEEDING, ETC SINCE 2005!! WOOHOO!

    On the down side, when my friends visit me and ask where I keep my supply of tampons/pads and I just cackle madly at them, they are not happy.

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    1. Depo-provera has a black box warning about bone loss during it's use, so that needs to be taken into account.

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    2. And there was a class action suit not that long ago due to the long term loss of fertility and other nasty side effects. No thanks.

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    3. I do get a bone density scan every few years to make sure I'm not having any significant bone loss - so far, nothing.

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    4. That's funny, because when I was on the shot, I had spotting for the Entire. Three. Months.

      Also I gained 50 lbs, had no sex drive, and was generally exhausted and cranky all the time.

      But I had been totally excited about that 'no period' thing, so it was really obnoxious to suddenly have one that just kept going.

      For other types of hormonal birth control, I've had the same problem... I can't go straight from one NuvaRing to the next, or I'll just spot the whole next month. It's like my body is going, "No, I need to have a period, and if you won't let me have it all at once, I'll just have to eek it out over the next month." Same if I ignore placebo pills and immediately start taking the next month's dose of hormone pills. I just bleed anyway.

      So. Annoying.

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  34. The pregnancy rates for condom use always confuse me. I mean, it's not like the spern can just magically burrow through a condom. Basically you have to mess up in some way, put it on incorrectly, re-use one (eww), not use it for the entire time of the intercourse, or forget it altogether. I mean, wouldn't you realise that you have messed something up? I'm wondering if the statistics count people who used condoms as contraception... "except for that one time".
    Of course the condom may split accidentally, but at least that should be fairly easy to spot and if (I know it's a big if in many countries) you have access to emergency contraception you could correct the situation, so to speak.

    Since condoms are the only effective prevention against STD:s, maybe it would be better to have more accurate figures as to how many pregnancies result after perceived correct condom usage. Hopefully people don't give up on condoms altgether "because they're so ineffective anyway".

    I tried the Pill for some years when I was in my early twenties, but it never felt good. I used condoms only for ten years, and only two times the condom actually split. I noticed that and took EC (easily available where I live). I didn't get pregnant even once during the 10 yrs, even though for the last year, my husband and I used pulling out or only putting the condom on after we had already started PIV. In case you were wondering if we had some medical factors preventing pregnancy, I got pregnant 4 months after we started trying to conceive :)

    So condoms/pulling out worked surprisingly well for us. Of course, we were in a stable relationship and knew we'd want children at some point, so the stakes were not so high.

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    1. "I mean, it's not like the spern can just magically burrow through a condom."

      Unless the condom-purchaser has an asshole roommate that owns a pin.

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  35. I have a Mirena IUD (my 2nd one!) and no periods, which is GREAT for me because I always had very painful and lengthy periods and have hated them like mad since I first got them. I don't have to spend $ on pads and tampons and no "off week" that inconveniences me.

    My parents tried the "fertility awareness method" for a while and my mother HATED it. She says, without hyperbole, that it almost destroyed their marriage as the daily self-examination and continual daily focus on her cycle by both she and my dad made her feel like she was primarily a walking uterus at a time when she was struggling to move on in her life beyond "wife and mother of four". She finally found a hormonally method that worked about the time she went back to college, graduate school, and a career. What I take from this other than "different things work for different people" is that your method of contraception also works at different points in your life for different reasons. :)

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  36. OK. I'm English, on the NHS, and can someone explain why gyno exams are needed for prescribing birth control? I've been on the implant, and didn't have any fuss beyond 'it works just like the mini-pill, so we're going to try you on that for 2 months so you don't commit to something that doesn't suit you'. None of my friends on hormonal BC have had exams just to get the birth control. I've had an examination, but only when I asked for one because something was worrying me.

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    1. I had an exam. Not the horrible rectal one, but I did have a regular checkup/pap smear. US laws require that if you're on any Rx medication for a long period of time, you receive an annual checkup from the prescribing doctor.

      It's partly to avoid people abusing stuff like painkillers and Ritalin, but it also helps ensure that the doctor knows if you, for instance, have side effects that SEEM minor to you but are actually symptoms of something life-threatening.

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    2. Late responding here, but I'll just say that I live in the US and just had my Implanon inserted 3 days ago, no exam. Managed to opt out of the STD panel, too.

      I think a lot of the reason that women in the US end up getting a pelvic exam when they get BC is because they go to an OB/GYN and the BC portion is an add on to a regular exam/visit, or an 'after pregnancy' check in (pure assumption, here, I went through Planned Parenthood to get a quicker appointment).

      I also don't have any regular/annual exams or follow ups scheduled, but then again, I won't be needing a new prescription or anything either, so that may be why on the no follow up.

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  37. I currently have a copper IUD and I really love it. The drawbacks (minor cramps and occasional spotting) are minimal and the benefits (spontaneous comfortable sex with my (monogamous and STD free) partner, no really shitty reactions to hormones) far outweigh them. I have a history of absolutely killer cramps, and even went on hormonal BC for them, and the copper IUD doesn't make them worse, in fact, they've gotten better. They last a little longer, but are controllable with a couple of ibuprofen (whereas before I'd have to spend at least half a day in the fetal position, sometimes vomiting from pain, no matter how many ibuprofen I took). Insertion was a total bitch and I had to be knocked out, but I also have a crazy sensitive uterus and a much smaller than average cervix (1/3 of 'normal' size), so it shouldn't be as bad for most women.

    Why I'm writing is because, for 2 years, I used withdrawal as my main form of BC. I chose the method after lots of absolutely awful experiences with hormonal and barrier methods, and finally in frustration I did a lot of research and realized withdrawal was the most reliable (I had LT trustworthy partner at the time with good self-control) barrier method after condoms (96 vs. 97% with perfect use), which my partner couldn't orgasm with on a regular basis and which I have a negative reaction to. I lied to everyone, including my gyno about it because I didn't want the lecture from people who haven't done research about how I was some ignorant toothless woman who was relying on Jesus not to have a baby, and let me tell you, I never ONCE had a pregnancy scare. In fact, the only time I've ever been pregnant was an ectopic pregnancy which wasn't prevented by a progestin only pill! So, again, it really really relies on you trusting your partner, but if you do and your guy has good self control, it actually is way more effective than many other forms of bc that won't get you laughed at if you claim you use them.

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    1. Was knocking you out an option to begin with, or something that ended up being medically necessary to complete the procedure, so they kind of had to? I ask because I am *dying* for an IUD but I am a huge wuss when it comes to pain, and most women I know who have them say insertion was so insanely painful that they probably wouldn't have gone through with it if they knew it was going to be that bad. I'm sure anesthesia policies vary from place to place, so obviously if your doctor offers it, I might not be able to find a doctor that does...

      Then again, my bigger issue is just finding a doctor to even insert an IUD. My current gyno who I otherwise love has basically just flat out dismissed my interest in an IUD by saying it's not a good option for someone my age, and who hasn't had children (I can see the risk/pain level for never having been pregnant, but age? Is it because youngins' tend to be having more partners? I'm about to be 25 and have been in the same monogamous relationship for almost 7 years...). Anyways, I'm sure my doc wouldn't give me anesthesia let alone insert this, and hearing how insanely painful and "risky"(according to my doc) it is doesn't make me sure enough of myself to go searching out a doctor who *will* insert one...

      Also yes to everything you've said about withdrawal! It gets such a bad rap, but we've used it successfully on and off for years - and for the record, I am also not an ignorant toothless woman relying on Jesus to not get pregnant ;). Seriously though, I get the concerns and risks and obviously it's not a great method for those who have just started having sex, teens, people not in monogamous relationship and not ready for the risk of pregnancy...but for those of us who are in a place where we're informed and aware of how to use it correctly and what the potential consequences are (and are prepared for pregnancy if it should happen), we shouldn't have to be ashamed. I hate having to lie to my gyno too...from what I hear, most women who use it do that, to avoid the lecture. >:(

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  38. I had a pretty good relationship with my periods until I was 45 (just mess and minimal cramping). Then they tried to kill me. It's as if my body was contemplating menopause but instead of shutting down the period-initiation code it shut down the period-termination code. A month of continuous worst-day-of-period bleeding is enough to put you in the ER, as I found out the hard way.

    After several tries we found that I can't tolerate estrogen psychologically, though it did stop the bleeding, but progesterone was fine, so I now have a Mirena IUD (the progesterone-releasing kind). I spot a little once a month but it really doesn't seem like a period, and I find that after the awful half-year trying to control the bleeding, that's best for me. I would be happier not to have another full period ever. I think I would be afraid that it wouldn't stop in a timely fashion. And, frankly, it's really convenient not to have them. I don't tolerate tampons and my experiments with the cup led to blood up to the elbows.

    Just out of curiosity, can anyone explain how you get the cup out without making a mess?

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    1. Hello Mary Kaye - not suggesting you try this because you do have a good solution for you, but I used to turn off my periods by taking huge amounts of good quality evening primrose oil from the start of my cycle. Sometimes I'd just start it whenever, and by luck hit the start of the cycle. Most times however, I could work out from the relative intensity of flow when my period should have finished and start the primrose oil then. It's worth sharing as you did because many women head for hysterectomies because of bleeding - and its only just a short time until all that finishes anyway. BTW - having had periods like a gushing tap, I can understand the blood up to the elbows thing! Good luck everyone! :-) C

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  39. I usually get blood on my fingers and sometimes my palms, but I've never gotten it up to my elbows. I reach up, pinch the base, pull it gently down until I can reach the rim of the cup with the fingers of my other hand, break the suction, and pull the cup the rest of the way out, trying to keep the plane of the top of the cup parallel with the floor. I hold it by the base to minimize squeezing blood out. Sometimes it hurts a little coming out since it's fully expanded.

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  40. Ergh, sorry, that was meant as a reply to MaryKaye!

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  41. and let me tell you, I never ONCE had a pregnancy scare

    My Great-Uncle Arnum smoked like a chimney all his life and lived to be 93. I'm glad it worked for you, but that doesn't change the numbers on how ineffective it is overall.

    Anonymous @10:19, there are two failure rates for ALL contraception: perfect use and actual use. Perfect use is "if you used this method exactly as directed without fail for a year". Actual use includes, whoops you forgot to put the condom on.

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  42. I don't think I've ever heard of a base rate. If you have sex with NO protection at all, what are the odds of conception? This would say something about how much any particular method of birth control actually helps. If the base rate is 30%, reducing it to 27% isn't worth much. If it's 90%, reducing it to 27% is pretty significant.

    I also have to question the idea of a rate "per year" (as in "The pregnancy rate (over a year) with typical use of spermicidal foam/jelly/film is 29%.") Surely the frequency of sex plays a significant role there, right? Assuming they use the same form of birth control, the person who has sex five times a week is a lot more likely to get pregnant (or make someone pregnant) during a year than the person who has sex three times, right?

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    1. Holly said in the post that the base rate was 85% (in the bit about spermicide being better than nothing). And yeah, of course that's probably assuming some goodness-knows-what average frequency of having sex (try the Kinsey Institute).

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    2. To participate in a study you have to have sex at least four times per cycle

      Delete
  43. Just throwing this out there, Holly.

    But it would be nothing if not hilarious (in the LMFAO, can't-catch-your-breath kind of way) if you were to suddenly spring on us, "By the way, this was all a grand social experiment, I actually can't stand birth control and I vote Republican! Kthxbai! :D."

    I'm thinking April Fool's Day?

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  44. I always wonder why we have government subsidized hormonal birth control and condoms, but not vasectomies. At $1300 a pop it's not cheap, but it works and prevents us from having more mouths to feed; now there's some bang for your tax dollar. Of course that's assuming family planning, responsible adults and a man who is not too insecure, macho or chickenshit. As an aside, I am troubled that I had to schedule a spousal approval meeting with the doctor for mine, but my then wife did not when she had Essure performed. The double standard for what is acceptable and permissible for a woman in control of her body and a man's control over his is disconcerting.

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    1. It's also assuming that there has been and will not be any special or even coercive pressure on the poor or on certain ethnic groups to get a vasectomy. There is a long and ugly history of that in the US.

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    2. In many places it's harder for a woman (especially a younger woman with no or few children) to get sterilized than a man. Double standards either way are definitely bad. Also, $1300? You wuz robbed. Planned Parenthood says the cost varies between $350 and $1000 (http://www.plannedparenthood.org/health-topics/birth-control/vasectomy-4249.htm).

      mythago, do you have cites on vasectomy pressures? The stuff I've read about inappropriate sterilizations has mostly been about women; I can't think of anything in the US where vasectomies were forced on men. Not doubting you at all, just curious. I'd love to see a class-based breakdown on current vasectomy status. I am inclined to think that these days it's mostly an option taken up by middle-to-upperclass folks, correlating strongly with decent health insurance.

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    3. Irene - Of course it's more difficult for a woman to be sterilized than a man! Think about it for a second, if you need to get a man's gonads, he pulls off his undies and they're right there along with all their tubing. If you need to get at a woman's gonads and tubing you have to cut into her body to even find them. That's major surgery. A doctor wouldn't remove your appendix just because you wanted him to, that would be irresponsible, and while there are more benefits to sterilization, it's still major surgery just like said appendectomy. Even the reversal of tubal ligation is surgery.

      When we're discussing other potential surgeries (like hysterectomies) there are other concerns like the hormone levels.

      Yes this does target younger women more than older ones, but there is inherently more potential cost to a young woman undergoing the procedure regardless of perceived intelligence. However, the other factor that is often neglected is the doctor should have the right to refuse elective procedures. If a tattoo parlor refuses to tattoo on hands or face, isn't that their right? What if they normally wouldn't do hand tattoos but agree to do so for the older man with a solid career than the 18 year old guy who thinks it would be a great idea? How is that different than agreeing to perform tubal ligation on an older woman with two kids but not the 18 year-old without any?

      I can understand where this is bothersome, but there are really solid reasons behind it.

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  45. If not uterine lining, what the hell are the slimy clumps that come out during my "period" on the pill? It's certainly not just bleeding but some seriously mucous stuff as well...

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  46. That first link is Crown condoms! Our favorite! Ignore the somewhat strange pink color they are great.

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  47. I would just like to point out regarding getting your period on the pill, that for me it would be a reason to start getting the pill. Since I am suffering from PCO I usually have a period every six months something like that. I have tried regulating with anything from p-pills to acupuntcure. Not because I neccesarily want to get pregnant right now, but because I feel disconnected from my body and have problems perceiving myself as an adult woman rather than a child. Therefor I would like to protest against the notion about male doctors. In some instances periods, with all that they mean of pain and uncomforability can be something you wish for.
    S

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  48. Mythago:

    Well, don't take my word for it, take the word of this thing called 'statistics.' Ya know, where people do things called 'research' and stuff and extrapolate across large populations and come up with valid results that hold for more than a single person. Withdrawal is 96% effective with perfect use. It's a lot lower with usual use, but so are almost all other methods (including condoms and BC pills) which rely on human error. If you trust yourself not to fuck up, then it works, well, almost as well as any other extremely effective method. My guess is there are far more people using withdrawal than will admit, because being treated like an illiterate fundamentalist Christian gets old, and so it's easier to lie.

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  49. Just a couple of things to add:

    You can leave the Nuvaring in for a whole extra week (i.e., use it for four weeks, then take it out and have a period as usual) without loss of protection. When I read the sheet that came with it, I was like, *ding* extra period-free week!

    All condoms sold in the US have to meet the same safety standards. The ones that are more expensive aren't more effective; they just have more marketing costs.

    I read that the reason the pill is set up so you have a period was more or less a marketing issue. When it first came out, people were really skeptical that a pill could really prevent pregnancy. Thus, they built in the period week basically so people would really believe that they weren't pregnant.

    I work in women's health education, so I really loved the post! Thanks, Holly!

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  50. hola! i've been on here a few times and i love it! just wanted to jump in on a positive note before i ask- WHERE are these statistics from?!?! because " It's certainly better than nothing (85% risk)," which seems to allude to an 85% risk of pregnancy for one year without contraceptive use, is pretty much reserved for peak female fertility (if i remember correctly, it's TEENS and maybe very early 20s). the statistic that's used for women older than that is actually 30%. which lasts until about age 30-35, and then declines exponentially... so if your risk of getting pregnant with the pullout method is 27%, its pretty much like using nothing...

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    1. Teenagers are actually very slightly less fertile on average than women in their early to mid-20s, and the 30% for 35+ is for the chance of getting pregnant in any one menstrual cycle, not for the year. I wouldn't be at all surprised if that translated to an 85% chance of getting pregnant within a year. But of course as the population ages you get more people who are subfertile or outright infertile without knowing it, so the spread around the average gets wider, and the average gets less meaningful for any individual woman.

      http://books.google.com/books?id=UOGpNfTGlrwC&pg=PT26 suggests that the likelihood of conceiving a baby within a year if you're trying to do so is about 80% up through 35. Presumably those in their 30s average more months to get pregnant, but the difference is not significant in terms of pregnancies per year.

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  51. "so if your risk of getting pregnant with the pullout method is 27%, its pretty much like using nothing"

    It's actually 3-4%, so there's a big difference between 4% and 85%. (Both statistics compare YEARLY rates, not monthly rates. Monthly rates vary between 0-20%). Condoms with actual use have about an 18% failure rate, whereas 'perfect' use is 3%. I don't see people telling anyone not to use condoms as a form of birth control or STD protection simply because with actual use they're not as effective.

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  52. I actually rolled my eyes at "highway rubbery." By which I mean I love you--because I would have done it if you didn't.

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  53. can exercise cause a delay in ones period? and how long after mensrtuation does ovulation occur? and is there something as a 'safe period' after mensrtuation?

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    1. 1. Yes, definitely.

      2. Roughly fourteen days. It varies some.

      3. I don't know about "safe periods" (in terms of pregnancy?) myself, but here's some information on fertility awareness ("rhythm method") in detail: http://www.plannedparenthood.org/health-topics/birth-control/fertility-awareness-4217.htm

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  54. Roughly half a year late, but I feel like sharing an interesting anecdote! Re: #5; you're probably right about male doctors today, but when the pill was first designed (by a male doctor) it did (mostly) prevent any sort of bleeding. That was changed when the first test group complained about it, and the company responsible for the research grew worried it would be seen as "unnatural".

    (For a bonus anecdote, when it was first marketed, it was advertised as a drug for people who suffered very heavy/irregular periods, with the "serious side effect" of preventing pregnancy. In Spain, that didn't change until 1976!)

    ((Sorry, this comment is a bit irrelevant. But I recently wrote a uni essay on the development of the pill and now try and shoe-horn it into conversations because it's really interesting.))

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  55. Hi, the advice on using regular pills as morning after pills is really useful. I want to add that there is a website by the Princeton University where you can look up how many pills of which brand in what time period to use to be safe (of becomming pregnant, at least). Coming from a country where morning after pills are not available over the counter and doctors tend to give you "Don't be a slut and you won't have to deal with this" speeches, this is highly convenient:
    http://ec.princeton.edu/worldwide/default.asp#brand

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