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» Scarleteen Boards: 2000 - 2014 (Archive) » SCARLETEEN CENTRAL » Sex Basics and Sexual Health » Birth Control Options

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Author Topic: Birth Control Options
ellecubed
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Member # 107532

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Hello all,

I got such a wonderful reception yesterday that I thought I would ask a second question today. *may trigger* I identify as a lesbian and only sleep with other cisgendered women. However, for most of my life I have been dealing with a group of people who think they own and control and therefore can do whatever they want sexually to me. This means that pregnancy becomes a risk.

Twice in the last week my well meaning doctor and nurse have said that I need to have a birth
control method on board because relying on plan b really isn't a plan. I find myself confused by this because I feel like the answer is that the police should be more adequate and these people should just not rape. But I still get where my medical team is coming from.

Complicating this is due to migraine issues I am not allowed to take HBC. Leaving very few options.

Have any of you ever been in this situation? Any advice on how to talk to my doctor about this? Any suggest on birth control to go on to if I cannot stay safe?

Thanks,
Elle

ETA: I noticed I accidentally posted this in the wrong category. Is there a way for me to move it?

[ 05-18-2013, 11:39 PM: Message edited by: ellecubed ]

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Karybu
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(There's nothing wrong with posting this question here, but let me know what section you'd prefer it to be in and I'll move it for you.)

First of all, I'm sorry you're having to think about this at all, and I totally agree that the police are failing you here in a big, big way. It's completely insane that you're having to make changes to your life because of what other people are choosing to do. [Frown]

My understanding of HBC and migraines is that it's generally only the ones with estrogen in them that are a problem, unless your healthcare providers have specifically advised you to stay away from hormones altogether. So, it might be that you could look into something like the mini-pill that only contains progesterone and not estrogen. You could look into getting an IUD - either the Paragard, which is non-hormonal, or the Mirena, which has a small amount of progesterone released locally - but since you are at risk of pregnancy due to assault rather than consensual sex, I'm guessing the risk of STIs that goes along with that would not make an IUD an ideal method. However, that would be something to clarify with your doctor. (If you're not already seeing a gynecologist specifically, it would be worth asking if they could refer you to one.)

That said, I'm not sure that Plan B isn't a good choice for you, depending on how often you need to take it. It's less effective than other methods, but if you had a few doses of it on hand and could take them as soon as possible when required, then it could be workable. If it's something you'll probably need once a week rather than every few months, then another method would probably be better just because of the cost and the fact that it throws your body for a bit of a loop, but I wouldn't rule it out entirely.

Unfortunately, there isn't much in the way of non-hormonal or progesterone-only methods that aren't condoms or barriers of some kind, but that should hopefully give you a place to start. You might also want to have a read through our Birth Control Bingo! article, and see if that gives you any more ideas.

As for how to talk to your doctor about this, I'm not sure what you're looking for with that: it sounds like you've talked with them a bit already, so could you clarify what more you're looking for on that front?

--------------------
"Another world is not only possible, she is on her way. On a quiet day, I can hear her breathing." -Arundhati Roy

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Heather
Executive Director & Founder
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Plan B is also one of the hormonal options that does not contain estrogen, so, like the others, it's not contraindicated for people with migraines.

Also, even with the migraines, are they migraines with aura? If they're not, then all methods are likely options for you. It's only migraines with aura where the estrogen + progesterone methods -- that's the pill, patch and ring -- are not advised.

--------------------
Heather Corinna, Executive Director & Founder, Scarleteen
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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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ellecubed
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Thank you both for responding.

Karybu: I noticed after that there was a specific birth control forum and thought maybe it would be better there. Thank you for all your thoughts on my options. I thought Plan B as a stand alone might be okay but maybe progesterone only would be a good idea. It is the estrogen that we are trying to avoid. I am absolutely terrified of the IUD. I am not sure if it is because I saw one when volunteering at Planned Parenthood a few years ago and it just scared me or if I am actually scared of it considering I know nothing about it.

Heather: I got two migraines with aura while taking my last HBC and both my family doc and Gyno said no to estrogen BCP after an MRI cleared there was no other issue. Just so I understand, I can't take the pill, patch or ring because of the aura?

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Robin Lee
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Yes, migraines with aura have been found to be exacerbated, for many people, by taking estrogen. A connection between migraines and estrogen doesn't generally exist for folks who get migraines without auras.

There are progesterone only daily pills. Here's some more information on them.

Progesterone-Only Oral Contraceptives (Minipills)

Would learning more about IUDs and talking about what concerns you have about them be helpful?

[ 05-19-2013, 11:05 AM: Message edited by: Robin Lee ]

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Robin

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ellecubed
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Hi Robin,

I think it would definitely be helpful but I find they are polarizing and I have yet to find decent information comparing them fairly and not either they are so amazing or the worst things ever. IUD's that is.

I will have to look at the progesterone only pills available in Canada.

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Robin Lee
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You maybe already have all this information, but I often find that a good place to start with these kinds of discussions is with all the facts. So, here's some info for you:

Intrauterine Devices (IUD, IUC or IUS)

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Robin

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Heather
Executive Director & Founder
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elle: so yep, if you have migraines with aura, it's the combined pill, patch and ring which many doctors (most, I'd say), would advise against. All other methods should be open to you, again, including Plan B, which is just as effective as the mini-pill, and not something you'd have to take every day.

I mean obviously, the best plan would be to get you safe so you are no longer assaulted, so I think focusing most on that would be best. But in the meantime, even just for peace of mind, having some BC method might make you feel better. But it likely doesn't need to be ongoing unless that's something you want.

--------------------
Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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ellecubed
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Thank you both Robin and Heather for sharing the information.

I was just reading about the things that would prevent one from being able to use an IUD. I am on immunosuppressants and therefore am immunesuppressed. Does that mean I cannot get an IUD?

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Robin Lee
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That means that you'd need to discuss it with your doctor. I don't think it means that an IUD isn't an option at all, but that you and your doctor would have to discuss that, together with the rest of your current health and health history, as well as other factors influencing which options are available to you, and figure out whether an IUD is appropriate for you given the entire picture. It could be that you being immune-suppressed means that an IUD isn't appropriate for you, but talking with your doctors is still a good idea before deciding that it is as they'll have a more personalized take on it for you and your needs.

--------------------
Robin

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ellecubed
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Thank you Robin. Is this a conversation to have with a gyno (less familiar with my entire history) or my family doctor (completely familiar with my history?)
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Karybu
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I'd be inclined to see a gyno, since they'd be more familiar with BC options and better able to determine what would be a good fit for you. Is there any way you can get the two to communicate? Usually in Canada you need a referral from your family doctor to see a gynecologist anyways, so it should be possible for your doctor to provide your history when they make the referral.

--------------------
"Another world is not only possible, she is on her way. On a quiet day, I can hear her breathing." -Arundhati Roy

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ellecubed
Neophyte
Member # 107532

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Hi Karybu,

I have a great doctor and gyno currently who do communicate with matters of my sexual health. I am thinking the best plan is to just ask my family doctor to start a discussion with my gyno about the best options going forward. As I am much more comfortable with my family doc and don't know how easy it would be to explain to my gyno I need birth control against sexual assault.

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