What are my longish-term birth control options?

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I’m a mama to the best two little boys around… and would not like to have any more. Yep, my husband and I are in mega-agreement that two kids are plenty for us. So, it’s time to figure out our long-term birth control plans. Ideally, vasectomy is what we’ll do, but my husband had MAJOR surgery this year and is not interested in any other bodily changes for a while.

Right now I’m on the pill, but after a panicky day of where’s-my-period last week due to my inability to remember to take the thing on time (or even within 12 hours of the right time), I’m motivated to check out other options that don’t require a daily commitment until my husband is ready for the big V.

So, what longish term birth control do you use and why? — NW Mama

We’ve only talked about permanent birth control (vasectomies and tubal litigation, anyone?) on Offbeat Mama… what not-quite-so-permanent options are out there?

Comments on What are my longish-term birth control options?

  1. It’s funny that this came up today, as I just had a Paragard (copper) IUD placed yesterday. I have one son that is a year old and we are not certain whether we want another. Hormones don’t work for me and I actually became pregnant in the first place because we were inconsistent with condom use.

    The insertion process was uncomfortable but not overly painful. I had to have it inserted during my period and it looks like the bleeding is about to stop today.

  2. I got the Mirena in May 2006. My body works better with a small dose of hormones as it actually reduces my headaches (weird, huh?). My periods slowed, then stopped by 2007. I got it removed in Feb 2010. We used condoms for March so I could plan out my period (I’m uber regular). I got pregnant in April. Babe was born in Jan 2011 and I got another Mirena in Feb. I hadn’t even had my post-partum period yet. Now, I still haven’t had a period. I do think that my body keeps an extra 5 -ish lbs because of the hormones, but that is worth is for the convinence.

  3. I have Paraguard, the HORMONE-FREE (!!!!!) IUD. It lasts 10-12 YEARS! And again, no hormones. I still get my period but other than that–no pill, no worries, nothin’. I’ve had it almost 3 years now and it’s been the best decision of my LIFE!

  4. I decided to go with ParaGard (copper IUD) for my birth control when I was a senior in high school — four years ago now. I’ve never looked back! I haven’t had any pregnancies or changes in my period (i.e., my IUD doesn’t make my periods heavier or more painful.) I had tried the Pill, the Patch, and NuvaRings as teen, all of which I either forgot, was annoyed by, or had hormonal issues with; in contrast, I don’t have to think about my non-hormonal IUD, and it has never made me gain weight, break out, or get mentally unstable. Initial insertion was uncomfortable and I was sore and crampy for about a day, but since then it’s been the easiest and most effective birth control choice I’ve ever made.

    Only caveat: twice (and I would stress that this is in a four year time span), when my husband and I have been having especially deep penetrative sex, I have experienced some severe cramping pain — my gynecologist said that he may have nudged my cervix a little roughly, which could have shifted the IUD slightly and caused the cramps. I checked it afterwards both times to make sure it was still in place; it was, I moved on.

    In summation: ParaGard! Fuck yeah!

    • So with your Paraguard, you still get a regular cycle? I kinda like the regularity and really get weirded out by the thought of complete cessation of periods even though my body’s still supposed to do the same hormone dance.

      • i’m with you on this. i don’t know why people think not having a period is awesome. the thought freaks me out. i have had mirena and paragard and have still had regular periods with both. cycles are kinda wonky right now with the paragard but i’m pretty sure it’s being caused by breastfeeding, not the iud.

  5. i have a mirena IUD which in general i would recommend without hesitation. i *have* experienced some significant negative side effects with it, but i’m well-versed in the research on it and know that i’m most definitely a statistical minority.

  6. I had the Mirena for 3 years before having it out in December last year and getting pregnancy in February. I loved it and I think it’s a great option if you’re looking for something to last.
    We plan on having another child within 18 months of this one due in November so I have been wondering what options people have gone with in this circumstance? I figured we’d just end up using condoms, but I’m interested in people’s experience with diaphrams? They seem to have gone out of fashion lately…

    • 6-24 pregnancies per 100 women using them for a year. Not to knock them. I’ve been using diaphragms for years, but always as a backup to another method.

  7. I use the Depo shot, and everyone yelled at me for it, but really I have had no problems, no scares, you just have to take EXTRA care that you dont have unprotected sex the first 7 days after you get it…any responsible person can achieve that. 🙂

    • Just want to quickly add about depo that it can take 6 months to 2 YEARS to regain fertility after just one injection. Not a problem for people who aren’t planning more children or won’t be in a hurry, I just know a lot of people (including myself) who weren’t aware of this and have been caught out waiting a very long time for ovulation to return.

      Other than that small but important thing, it was great for me.

  8. I’m a big implanon fan. I’m getting it put back in in a few weeks. I had some light bleeding for the first 6 weeks or so and then almost none for 3 years. As someone who had the kind of period pain that required a day in bed curled up in a little ball popping paracetamol, the no period thing was a massive bonus for me.
    As for drop in sex drive I’m not really sure, I’ve always had a high one and it’s still high. Weight gain is something I’m not sure about as I was 18 when I got it put and in since then I’ve gone to college and had considerable lifestyle changes which were more likely to contribute to me gaining weight that the hormones.

  9. Just gotta chime in since I didn’t see any similar comments: I had the Paraguard/Copper T IUD for about a year and absolutely loved it…UNTIL I suddenly was having super heavy, super painful periods that didn’t seem to end. It took me a couple of months to realize how bad it had gotten before I finally went my new gyno (not the one who inserted it) and was promptly diagnosed with a raging pelvic infection. After the infection didn’t resolve with a course of antibiotics, Dr. recommended removal of the IUD and I agreed. It took two more rounds of antibiotics to get the infection cleared up. I don’t think my experience is typical, but please pay attention if you have an IUD and start experiencing unnaturally heavy periods (think soaking a pad/tampon more than once an hour) and pain. I don’t know why I ignored the symptoms so long. Also for the record – I thought the insertion was terrible and was not warned at all by my old gyno how painful it would be (I have never been pregnant so I know that’s a factor.) But – the removal is no big deal at all. Not trying to scare anyone at all with my story- IUDs are awesome and I still recommend them to any ladies looking for non hormonal, long term birth control. Just be aware that not all heavy bleeding while using the Paraguard is normal.

  10. I’d like to note that IUDs may now be FREE depending on your precise insurance situation. I had a 6 year old Mirena removed in …May? after 5.5 period-free years, and I’m currently using condoms while I decide if I should get another Mirena. I loved the no-periods, but it kind of flattened my sex drive. Now that I’m off hormones entirely for the firs time since i was 16, I’ve realized that my natural rhythm includes an ebb and flow of my interest in sex through the month, from SUPER HIGH when I’m ovulating to FUCK NO at the beginning of my period. With the Mirena, it was all “medium”.
    So I’m now deciding between a Mirena or a Paragard, and weighing ‘no periods’ against ‘more fun sex drive’ (and unexpectedly, my partner has come out in favor of the no-hormones plan). Before the healthcare reform changes, I was also counting in ‘cost’ as a factor (Mirena costs about 50% more), but now…IDK. It’s a weird place to be, because I LOVED not bleeding from the vag, but I also LOVE the hormone-free sex drive (as in, turns out my sex drive didn’t decline after my mid-teens, I just put it on too many drugs).


    But long story short, whichever you pick, GET AN IUD. It’s going to suck to get inserted, and suck for the first few weeks, and then it’s going to be fucking awesome for the next several years.

  11. I’ve used both the Mirena IUD (with hormones) and the ParaGard copper IUD. Both were great. I did have heavy bleeding with the ParaGard, though, and that got old after a while. I had it taken out when I decided to try and conceive, and after the pregnancy opted for the Mirena. No periods, no hormonal side effects (other than no periods 🙂 ), I am sold.

  12. I thoroughly recommend the Mirena coil. It *can* be fitted in women who’ve not had children, it’s just technically a bit more difficult to do. That doesn’t stop them being fitted in childless by general practitioners here in the UK- in fact my last GP was at a student-only medical practice and they actively promoted the Mirena to their patients who were almost universally women who’d never been pregnant. My own experiences have been excellent, so much so that I’m now on my second and I have to say I can’t ever imagine using a different contraceptive. My periods have stopped entirely (and safely- no build up of uterine lining!), I’ve got incredibly reliable and convenient contraception without the systemic effects that hormonal contraceptives usually bring. I tend to promote the Mirena to my patients as the safety profile is so good and it’s so reliable.

    TBH though, the best person to speak to would be your doctor. Every woman’s experience of every contraceptive will be different.

  13. I used the Nuvaring for 5 years before baby and now post partum I am going with the Depo shot since I plan on breastfeeding. Depending on what kind of hormones you can take will depend on your options.

  14. ring! I had an IUD for two years, but it became very painful…there’s also a service that will text you a birth control reminder, i LOVE it, after two accidental and unwanted pregnancies ending in expensive and painful terminations it definitely gives me peace of mind.

    here’s the link.

  15. I tried the copper IUD, and wound up not caring for it because it increased my cramps and both the quantity and length of flow. I gave it 6 months to even out and for every 30-day cycle, I was still bleeding my regular 7 days (1 or 2 days of those heavier than before), plus an additional 10 days of spotting to light flow. My gynecologist said that about 1/3 of her patients have their IUDs removed because of problems like these. But I’m glad I tried it, and I hope the 2/3 who keep theirs are deliriously happy with it.

    Now I have the hormone-releasing IUD (Mirena) and I love it. Some women don’t get periods at all with the hormone-releasing IUD. I do, and for the same 7 days I’ve always had periods, but the flow only ranges from spotting to light flow. (so light, in fact, that instead of using feminine products I just wear dark-colored underwear).

    IUDs can be painful to insert. I haven’t had children yet, and my first IUD was about 30 seconds of very intense pain. The second one was slightly uncomfortable—like a pap smear—but not painful.

    The main concern with IUDs (of any kind) is that they can give STDs an entryway up into the uterus, which can scar the fallopian tubes shut. Therefore they are not a good choice for anyone who can foresee any STD exposure.

    A much more minor concern is that your partner may be able to feel the string (which is kind of like a fishing line) poking him during sex during the first couple of months, and he may prefer to avoid deep penetration during that time. But, the string usually curves to conform to your body after a month or two, and no more poking.

  16. I really really recommend reading the book “Taking Charge of Your Fertility.” Learning to understand how my fertility cycle worked–and how to track it–was an amazingly empowering feeling for me, and I also don’t have to use any “artificial” form of birth control now. I’ve been successfully doing this for 2 years. Depending on your particular cycle, lifestyle, etc. etc., natural birth control may not be a good option for you….but I still think the book is worth reading!

  17. As a physician, I think either IUD is a great option. Everyone’s body is different and reacts different to the hormones in birth control. Everyone’s uterus can also respond differently to having the IUD placed there. Usually, with the placement itself, it is more painful in women who have not had children before and less with people who have had one child. Even less uncomfortable with those that have had multiple children vaginally (or at least dilated during labor). The placement is usually pain free if placed about 6 weeks postpartum. I just placed one in a lady a few days ago, who is overweight, dilated about 5 cm during labor but had to have a c-section because of a fetal arrhythmia. The placement went great and she had no associated cramping. However, like I said above, everyone is different and some have a lot of cramping with placement. You leave the strings long for about a month and then trim them if needed at your next check. I think the strings feel like fishing line, so they can be pokey on your partners penis during intercourse at times. The strings can always be trimmed if this is the case. I enjoy reading all the comments about because I think all the experiences are true and reiterates that everyone is different. You need to figure out what is best for you but I think it is worth trying either one of the IUDs. It sounds like a great option for what you are looking for. It might be a great idea to further discuss this with your physician or a group like planned parenthood! Good luck with your decision!

  18. I have the contraceptive implant in my arm, which is great, but I’ve noticed it’s never mentioned on US-based forums, so I presume it’s not available there.

    Lasts 3 years (but is removable) and can be used while breastfeeding, so I had it fitted ASAP after my son was born. It will easy to remember when to speak to the docs about replacing it – on his third birthday!

  19. Now granted I have lots of issues with plenty of different hormones for multiple reasons but I was on Nuvoring for a couple of years and while it was incredibly convenient, I had all my normal period side effects magnified – cramps, flow, fatigue, mood swings, acne etc. Though really, while it sucked, I hardly noticed how much worse my periods were until I quit using it. And while my partner could feel the ring, it was funny as hell when he got a ‘hole in one.’

    On a different note, a friend of mine though had a horrible time with mirena after her baby. She had preeclampsia and still had high blood pressure afterwards so her doctor didn’t want her on the pill anymore. She ended up getting pregnant anyways a few months later and resulting in a miscarriage. Although when she was back on the pill she got pregnant again anyways and everything looks healthy as she hits her second trimester.

  20. Under the Affordable Care Act (aka “Obamacare”), beginning September 23, 2010, all FDA-approved forms of contraception including sterilization are available with no cost-sharing (no copay, deductible, or coinsurance). That means that not only can you get birth control pills for free, you can get any FDA-approved method. I have so, so, so many reasons for advocating the IUD that I dedicated a post on my blog to it 🙂

    Obviously, call your health insurance first before getting one so you make sure you go through an in-network provider, etc. Or if you don’t have insurance, check with Medicaid, Planned Parenthood, and other clinics to find out how you can go about getting your free contraception. Even if you end up paying out-of-pocket, the up front costs is cheaper in the long-term than the monthly pharmacy bill. For more info go to http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html#CoveredPreventiveServicesforWomenIncludingPregnantWomen

  21. I know that these comments have gotten long and thorough – but I wanted to link to Rebecca Woolf at Girls Gone Child – who had a genuinely awful experience with the Mirena between her second and third pregnancies & is currently having a very unpleasant time with her paraguard

    Mirena – after her removal, with links to the previous posts

    This post contains her paraguard problems – lots of good comments

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