Back in my late teens and early twenties (f*ck, I’m so old), I tried four different birth control pills. No matter which pill I was on, I kept feeling like a raging bitch with zero control of my emotions, getting killer headaches, and gaining a bunch of weight from being super bloated all the time. The pill definitely helped to manage my ovarian cysts and keep me from getting pregnant, which is great, but I don’t plan on going back on it ever again because of how negatively it impacted my mental and physical health.
So WTF do I do now to not get pregnant and die? Nothing! JK. I’ve been using a combination of condoms and the calendar method via a fertility tracking app (shout out, Clue), which works well, as long as you know when you are and aren’t ovulating. Although my flow is heavier without hormonal birth control, I feel my (painful) ovulation, my cramps feel like a baby monster is crawling its way through my reproductive system, and my cysts are pretty bothersome every month now, I’ve felt SO much better, in control of my feelings, and like myself again. 10/10 would recommend ditching the pill and doing the same (health permitting, of course).
Don’t get me wrong. Just because hormonal birth control pills didn’t work well for me doesn’t mean they aren’t going to work for you. They’re a super popular BC method for a reason. When you actually remember to take them (endless thanks to phone alarms), birth control pills with estrogen and progesterone, or just progesterone, can help suppress ovulation, regulate abnormal cycles, reduce acne, decrease heavy flows, and manage ovarian cysts from PCOS. They’re easy to take and can also be pretty cheap depending on your insurance, which is why it’s traditionally the go-to BC method. “For young women who aren’t ready to have a child and would like to decrease the risk of having certain types of cancers, prevent unwanted pregnancies, the use of birth control pills is probably the best option. When ready for pregnancy, pills can be stopped and pregnancy can be attempted without any delays,” says Aykut Bayrak, MD, fertility specialist and founder and Medical Director of LA IVF, a group of fertility clinics in Southern California.
HOWEVER, there *might* be some ugly side effects if this is your main method, which I experienced first-hand for a few years. Let’s just jump right into the worst of it. According to Kecia Gaither, MD, MPH, FACOG, double board-certified in OB/GYN and Maternal Fetal Medicine, Director of Perinatal Services at NYC Health + Hospitals/Lincoln, using oral contraceptive pills (OCPs) long-term may increase risk of breast or cervical cancer (but decrease risk of uterine, ovarian, and colorectal cancer!) and may increase liver tumor formation (which is rare). Greattttt. On another note, Bayrak says the short-term cons may include headaches, irregular bleeding, bloating, spotting in the first few months, irritability, mood swings, and increased risk of clotting. “Most side effects tend to decrease or disappear after a few months or can be managed by trying different brands that can typically have a different dose and combination of hormones,” he adds.
All this is to say that if you’re not loving how you feel on the pill and want to switch to a non-hormonal birth control, there are options out there! Here are eight popular non-hormonal birth control alternatives and each of their effectivity rates.
IUDs (99% effective)
Don’t wanna be pregnant for a while? Don’t mind undergoing a quick procedure? Gaither says that an IUD can last about 10 whole years. “An intrauterine device (IUD) is a highly effective, non-hormonal method where a T-shaped small device is placed inside the uterus which prevents pregnancy at a rate of 99%,” adds Bayrak. He notes that it can cause cramping and some irregular bleeding on the short run, but it’s generally well-tolerated in the long run. TBH, I’ve heard both horror stories and happy endings from friends who’ve had IUDs, so beware of the pros and cons before getting one. And, to be clear, there are IUDs that use hormones, so I’m specifically talking about the copper one here.
Condoms (98% effective)
“Condoms are the worsttttt. They remove all feelingggg” –f*ckboys everywhere
Suck it TF up. Condoms are a great alternative to taking that damn pill every day. “Condoms are recommended for all women who do not have a steady partner to avoid pregnancy and sexually transmitted diseases,” says Bayrak, adding to keep in mind that they must be used from the BEGINNING of intercourse until AFTER ejaculation occurs to avoid pregnancy and STD exposure. (Meaning, no, f*ckboys everywhere, you can’t just use it for the first few strokes and call it effective.) Condoms are highly effective (98%!) when used properly. Just always check for holes, tears, or package defects before using.
Diaphragms (80-95% effective)
The only time I’ve ever seen a diaphragm was in 8th grade health class. Like, I’ve never known anyone under the age of 50 cop to using one. But apparently they’re super effective, so joke’s on us. “Diaphragm is a highly effective barrier contraceptive method when used properly, but not so much popular any longer due to difficulty of use and placement,” says Bayrak. On that note, they’re user-dependent so their effectiveness ranges from 80-95%. Gaither clocks in the average effectivity rate at 94%, though. Plus, I saw a tip once (not a d*ck joke) where you can cut a condom to create a diaphragm at any time, so this might be a good idea… just saying.
Permanent solutions (99% effective)
If you already have kids and don’t want any more, or if you know for certain that you will never ever want kids, there’s a permanent birth control method for that. “Tying of the tubes (tubal ligation) or interruption of the male tubes called vasectomy are highly effective methods,” says Bayrak. 99% effective, to be exact. Remember, this is a PERMANENT option so there’s no going back after you do it. But if you’re absolutely sure kids are not in the cards for you, it’s an option.
According to Gaither, other non-hormonal contraceptive options include cervical cap + spermicide (failure rate 14-29%), spermicides (failure rate about 25-28%), sponges (80-91% effective), and family planning (75-88% effective). Just remember that certain methods (like calendars and IUDs) don’t protect against STIs, so be careful and always use the right forms of protection where necessary. And as with any type of BC option, she reminds that “it’s best to consult with your health provider as some pre-existing conditions may preclude the administration of certain types of contraceptives.” May the healthiest odds of preventing pregnancy be ever in your favor.
Images: Pexels, GIPHY (4)
For most of us, birth control is a necessary evil. Like doing our taxes, or pretending to enjoy giving blow jobs (just me?). It’s the thing we joke about when our alarm goes off during happy hour, the thing we bitch about when we’re overly hormonal, or feel grateful for after a hookup goes awry. It’s a thing we hate sometimes, but can’t—or won’t—live without it. And if you think I’m being overdramatic with that statement here are the
receipts facts: according to recent studies, nearly two thirds of American women use contraceptives in some way, shape, or form. I should know because for the last 15 years I was one of these women.
If a friend told me they were goingn to go off birth control, I would act aghast. “You can’t be serious. I don’t know who I am without it,” I’d joke. But it wasn’t really a joke. I was 12 when I first started using birth control. I had a heavy period that would come every 10 days. I was bleeding more days out of the month than I wasn’t. My doctor recommended me going on the pill to regulate my periods and my mom, who had nothing but good experiences with birth control, was all for me trying it out. Fifteen years later, I never looked back.
Being on the pill felt like an extension of myself, like an arm or the gel manis I can’t live without. There was never a question of me not being on it. To be totally fair, I never seemed to have the issues most of my friends had with the pill. I didn’t have crazy mood swings or weight gains. If anything, I felt like going off the pill would cause those kinds of side effects. My personality is already a fun mix of dark cynicism and the occasional rage blackout, I don’t need to f*ck with my hormones on top of it.
But I did end up going off birth control. For me, the decision wasn’t so much of a conscious choice as it was necessary to my finances at the time. When I was 26 I quit my job in the city to move back to my home state to be closer to friends and family. I quit without having another job lined up, which meant forgoing a monthly income—and health insurance. Being on my parents’ insurance was out of the question because I’d just aged out before quitting my job. My only options were to pay out of pocket or look into COBRA, a new law that lets you stay on your previous employer’s health insurance for up to 18 months after leaving your job, but it was going to cost me HUNDREDS of dollars a month. With no new income coming in and my bank account practically hemorrhaging money from my move across state lines, I chose to save money and forgo getting health insurance completely. Bye-bye, birth control.
At the time I thought I would find a new job in a few months and be back on birth control by Christmas. I was unemployed and living at home with my parents and, if my dating app matches were any indication, that wasn’t a great look for picking up guys or having sex. I guess living off parental pity isn’t as sexy as I thought it was? Who knew? So, I thought, if I wasn’t having sex, then what was really the harm in going off it? Sure, there’s the crazy mood swings that might manifest, but, as I was living at home, so only my family would have to endure those and they’re genetically obligated to love me anyways. Right, mom?
So I decided to go off birth control with the sole intent of not making it a permanent situation. I don’t know what I expected when I stopped taking the pill. The metaphorical floodgates to open and to start bleeding uncontrollably? I pictured my first period post-pill to look a lot like Carrie after they doused her in pig blood. That I’d bleed for an entire month and ruin every piece of underwear in my possession. I expected my acne to get worse, and to be rocking in a corner somewhere with all my ping-ponging emotions. But that’s not what happened at all. In fact, after I went off the pill I didn’t get my first period for 8 weeks, and when I did get my period it only lasted 4 days. I was shocked. The whole reason I went on birth control in the first place was because my periods were heavy and long. Post-pill, they were short and light. Manageable, even. Other than my cramps being a little worse than normal, my periods were a lot like the ones I had while on the pill. This doomsday mentality I’d crafted around being off the pill was just that: a mentality. It wasn’t real.
I thought being on birth control gave me a sense of safety—and it did, don’t get me wrong—but being off the pill made me feel empowered in ways I didn’t expect. For one, it helped with my anxiety. I used to obsessively try and plan out my periods by skipping pills in the pack so I wouldn’t have my period on the weekend or on random days during the week if I had an important work meeting or something. If I wasn’t planning out a period, then I was constantly trying to hound my pharmacist for my prescription. If the pharmacist couldn’t refill my prescription on time and I couldn’t start my new pack of pills within the first three days after my period, I would panic and have a breakdown. I can remember crying in my office because the pharmacist told me my insurance had changed last minute and I could only refill every 31 days, so I’d need to wait a few more days to pick up my prescription. Crying in my office! And not even over something reasonable like my office nemesis eating the last everything bagel in the break room.
Sure, I could have tried another form of birth control, one where I don’t need to worry about monthly prescriptions or even getting a monthly period, but the pill was so ingrained in my life that I truly thought I couldn’t function without it. I’d heard horror stories of friends getting the birth control implants in their arms and bleeding for weeks at a time, or having to fish an IUD out like an errant tampon. The pill worked for me. My periods were light and manageable. My skin was clear, my hormones weren’t making me crazy (aside from what just comes naturally with my personality). Sure, it caused me stress and anxiety, but wasn’t that worth it in the long run? And if I went off it or tried something new, who would I be then? I’d been on the pill for 15 years, over half my life, and I was terrified to make that change.
Then there’s the sexual aspect to it. For my entire adult life I’ve been on the pill. I was a late bloomer so when I started having sex in college, I’d already been on the pill for six years. Six. Years. That’s, like, almost the entire length of The Buffy The Vampire series (sorry #Spuffy fans, but I don’t count the 6th season because it was trash!!). My uterus was practically a cement fortress at that point, and boy did I love to test the limits of that fortress. I felt invincible because I didn’t have to worry about getting pregnant, but at the same time I felt powerless. I was constantly having to fend off arguments from guys as to why I still wanted to use condoms, as if being on birth control gave them free reign over my body. There were times when I felt like I couldn’t say no, like wanting to protect my body from diseases was too flimsy an excuse.
This is something I have to work on personally. I know this. Standing up for myself in my relationships with men, and also not choosing to date flaming piles of garbage masquerading as human men. But that doesn’t change the pressure I felt during those instances. I felt like I was solely responsible for providing the contraceptives during sex because I’d been on the pill for so long. Once I went off the pill, I thought having sex without that added protection would be scarier, but it wasn’t. I didn’t feel like it was just me having to be responsible for safe sex anymore, I felt like I was in a partnership again.
Look, I’m absolutely not advocating that women go off birth control or refuse to use it. I’m advocating that everyone should do what’s best for them. Women need birth control for more than just sex, and my experience is proof of that. But since I’ve been off the pill I’ve felt more at ease in my own body. I don’t feel anxious about my period or refilling a prescription. I feel more confident in my sexual relationships. These were not the emotional or psychological reactions I expected to have when I stopped taking the pill. I fully expected to feel more anxious, more out of control, powerless. I didn’t realize how much pressure this one, tiny thing had over my life until I was off it. And, to be fair, I got lucky—there are women who do experience side effects after stopping birth control, such as a heavier, irregular period; shedding hair; breakouts; and decreased libido, so just because I felt completely normal does not mean that you will too. Everyone is different, I’m just saying that for me, my choice to go off birth control did not have those drawbacks.
It’s been seven months since I made the decision to go off birth control. I have a job and health insurance again, but I still don’t know if I’ll go back on the pill. Or if I ever will. After 15 years of taking a pill every damn day of my life, it’s been nice to take a break, to not have to worry about medication. Will I feel differently in a few months? A few years? When hell freezes over and I finally get in a long-term, committed relationship with someone? Maybe. But for now, I’m not looking back.
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