Birth Control Bingo: Hormonal Methods Without Estrogen
On the previous page, you said that you wanted a hormonal method, but that you:
- smoke (and plan to continue smoking, or know you can't commit to quitting yet)
- have migraine headaches
- breastfeed an infant currently
- know you are sensitive to estrogens
- or have you had bad side effects with hormonal methods which contain estrogen before?
You still have a few choices, as there are hormonal methods which you can still use safely, and without most of the effects of estrogens.
Which of the following statements sounds most like you:
I CAN handle taking a pill every day of every month -- within a three hour window every day -- without fail
AND I do still want to have a menstrual period, but understand I may still have some mid-cycle spotting
AND I want a method which I can easily stop using, on my own, on any given day (understanding it will then no longer be effective)
AND I prefer taking pills to injections or minor surgical procedures and devices inside my body
I CANNOT, or suspect I cannot, take a pill around the same time every day without fail
AND I am okay with the likely possibility of absent periods and with unexpected bleeding or spotting
AND I am okay with a method where I either may have to wait a while for the effects to wear off, or for a return to full fertility, or where I will need to see my sexual healthcare provider to have the method removed
AND I prefer injections, minor surgical procedures/devices in my body to taking pills.
If this sounds most like you, keep reading.
Three possible methods remain for those who want a hormonal method without estrogens, and who either cannot or do not want to commit to taking a pill every day: a contraceptive implant, the Depo-Provera Shot or an IUD. Let's narrow things down further to find out which of these three options may be best for you.
First, would you prefer or do you need no hormones at all? If so, click here and look at the information for the Copper-T IUD. If that doesn't look like the thing for you, then you may want to start over, either by looking at other non-hormonal methods, or by starting back at the top.
If you're okay with hormones -- knowing we're not talking about estrogens -- or you don't have a preference or sensitivity, keep reading.
Which of the following sounds most like you:
I can deal with likely weight gain, potentially even a substantial gain
AND I would prefer an injection to a device being inside my body
AND I am not in a long-term committed relationship, or am not able to be consistent with and assertive about my partners practicing safer sex to the letter
AND I can live with negative side effects which may possibly continue months or maybe even (though far less often) years after I have discontinued a method
AND I want or can live with a method I need to get every three months
AND I can take a calcium supplement every day to protect myself against bone loss from a method
ANDI suspect or know that I am not able to get an IUD or an Implant, and know I cannot use estrogen, but want a hormonal contraceptive.
I feel okay with leaving a device in my body to provide longer-term contraception
AND/OR I suffer from serious depression, or have concerns about possibly major weight gain
AND I want or can live with a method which can last anywhere from three years to twelve years
OR I cannot commit to a schedule of renewing my method every three months
AND I want an easily reversible method where side effects will not likely continue after I discontinue use.
If this sounds most like you, keep reading.
We're down to two more methods, so it's time to make a couple final choices. Which of the following two groups sounds the most like you?
I am NOT in a long-term committed relationship where my STI risks are minimal or I am NOT easily able to be assertive and consistent about safer sex practices with partners
AND I am comfortable having a device in my body, but would prefer it in my arm rather than in my uterus
AND I cannot easily get health care on the fly or cannot commit to yearly sexual health exams
AND I have not been pregnant before, or am a young teen
AND I can deal with unexplained bleeding or spotting, even if it's something I may have to deal with every day of the year
AND I prefer a method which will be effective with one insertion for up to three years.
I am in a long-term committed relationship where my STI risks are minimal or I am easily able to be assertive and consistent about safer sex practices with partners
AND I am comfortable having a device in my body, but would prefer it in my uterus rather than in my arm
AND I can easily get health care on the fly and can commit to yearly sexual health exams
AND I have been pregnant before, whether or not I have had a child or terminated, or am not in my early teens
AND I prefer a method which will be effective with one insertion for up to twelve years
AND I can deal with unexplained bleeding or spotting for a couple of months, and then every now and then.
If any or all of those things DO NOT work for you, AND if none of the options for methods before that last question worked either, then you may want to consider a different hormonal method, or a non-hormonal method. Or, you may want to start over from the top of this page to see if you can't strike a compromise somewhere, such as by being willing to deal with some weight gain or spotting, or to commit yourself to safer sex practices completely.