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Author Topic: Birth control options
pinkskies
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Hello,

Although I realise there have been lots of questions about birth control on here I'm looking for some help due to my personal background/ health which influences my choices! [Smile]

I used to be registered as another user on here but I've now lost the login details.

I absolutely do not want to get pregnant. Absolutely not. I have avoided any kind of penetrative sex after the first time I had it I (stupidly) encouraged him to continue WITHOUT A CONDOM! Stupid, I know. I got EC pretty quickly though, and thankfully it was okay, despite precum scare etc. That was a long time ago, about a year and a half ago, and I relatively quickly ended the relationship after that for several reasons. It wasn't a very healthy relationship, and I needed time out of relationships.

The EC however, led to what I would describe as quite quick (as in quick to arrive) depression, compounded by my realisation (/ I stopped ignoring the obvious!) that the relationship was not at all healthy. I think I managed to acknowledge that things were not healthy before it got drastically worse, but I am now concerned about hormonal birth control options due to the effects EC had on me.

I have also suffered from vaginal infections when I was younger, and although my physical health is generally okay, when I've had infections elsewhere they have been quite difficult to get rid of, sometimes needing many courses of antibiotics, which has made me a little concerned about things such as the coil.

After a long time not in a relationship, and not even looking for a partner, I've met someone who I decided I do want to spend time with in a relationship. I feel he's someone I see myself learning to love, and that I trust him. We have very different relationship dynamics to my other relationship, in a positive way. It's much more open, and has always been so since the beginning. We talk much more, and have more open, frank discussions about everything, including sexual health, what we like, what might not feel so good, that we should get tested again.

I am thinking condoms, used with a more mature outlook (I can't keep hating myself for one mistake for the rest of my life, even if I do regret it!) and buying EC to keep at home incase the condom splits, might be the best option, due to my concerns about infections and hormonal interferance? I also worry about the build up of hormones in my body- can it really be good to take the pill for years on end? etc.

He gets tested regularly due to the nature of his work (laboratory-based), and I was tested in my last relationship (clear) and am going to be tested again soon. He's also going to be tested again to be sure. [Smile]

I'm sorry this is such a mammoth post, but I think it's important I consider the options. I don't want to rule penetrative sex out forever just because I messed up one day, and because of the EC's repurcussions. And although I do enjoy other ways of pleasuring myself and my partner, it would be nice to know we can have safe, penetrative sex, without worrying about me getting pregnant...

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Heather
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This is all helpful information. Let me ask a few follow-up questions though, okay?

Have you ever had any history of depression before? I ask that because depression with the hormone that is in EC, which is used for such a short time, would not be a common side effect. However, just know that that particular hormone is only in a couple other methods or brands, not all hormonal methods.

The vaginal infections you have had, have these been yeast or bacterial infections?

And here's some follow-up information:

The pill is THE most thoroughly tested medication in the world. Seriously. The reason why isn't so great -- basically, it was religious or cultural objection to women having such an effective method of birth control -- but the end result of all that is certainly helpful: we have a lot of information on it. And yes, it really is safe for most people, and the hormones in it don't "build up" in your body just like the hormones you already have -- which it's mimicking -- don't. Mind, the pill still may not be the best choice for you, but overall, yes, it's very safe for those who are the right candidate for it.

EC as a backup plan is a great plan. But if you're worried about a lot of hormones, you just want to make sure it's not something you wind up using regularly. It also is pretty unaffordable on a regular basis, and because of the dosage of it, a person who takes EC often is likely to deal with more side effects than someone who uses a hormonal method meant for daily use.

--------------------
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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pinkskies
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Thanks for the quick reply.

I should probably have added that I've recently had a few sessions of counselling, after the gentle suggestion of a friend, which has changed things greatly, even though we were concentrating mostly on family stuff.

No history of depression, I've never had anything like that of such intensity before, which is what was even more terrifying.

Yes, the vaginal infections were yeast and bacterial. I haven't had them for a few years, though when I was younger I suffered a lot from them.

I feel so glad to just be discussing this properly, to actually be ready to disucss these things rather than ignoring them. My clinic appointment is tomorrow too.

I would only want EC if condoms failed. Hopefully I wouldn't have to use it, but the security of having one at home would give me more comfort (if EC places are shut, for example!)

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Heather
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I would guess that the depression was not chemical, but situational, then. In other words, while the big dose of levonorgestrel may have upped the ante with it, had you not been freaking out about what happened and realizing your relationship was unhealthy at that time, that *probably* would not have happened.

If you kept going back and forth a lot between yeast and bacterial infections, some of why may have been being put on antibiotics all the time: antibiotic overuse -- and unfortunately, a lot of docs treat like that -- can actually cause a cycle of infections to persist.

All the same, the thing to know is that chronic yeast infections would probably mean you don't want to consider methods with estrogen in them (combined pill, patch, ring), as that can make yeast infections more likely. Chronic bacterial infections would indeed be a bad mix with an IUD. But if you haven't had them for a few years, both may be a nonissue now.

Before we talk any more, why don't you go walk yourself through the birth control method assessment tool we made a while back, here: Birth Control Bingo!

What'd I'd suggest you look at, assuming that the history of chronic yeast is probably the biggest thing we'd want to be careful about, is non-hormonal methods or progestin-only methods.

After you do that, if you want to pop back with any information that have you -- or if it inclines you to decide you do want to stick with condoms and EC as a backup, and know how to best use both -- so we can discuss it, I'll be around.

As a P.S., given your age, your cycles have probably regulated by now. So, if you want, we could also talk about how to combine charting fertility with condom use AND emergency backup of EC if you liked.

[ 06-29-2009, 09:39 AM: Message edited by: Heather ]

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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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pinkskies
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Yes, that sounds about right. The combination of everything altogether and me realising that this was not making me or him happy and that we'd be better not in a relationship.

I think I had a fair bit of antibiotics for them when I was younger, yes, and also some creams. Last time I had it was a year ago, I hadn't had it ages before then, and what seemed to help most was actually natural yogurt!

Oh, also... some more info is that I used to have really bad migraine headaches. I don't get them hardly much anymore, in fact I only had them awfully in my last relationship. I feel much healthier now!

My cycles are also almost 100% regular. I can get it down to the day, mostly, which is quite lucky I suppose.

Do you think there are any pills which would be progestin-only? Because I'm in England I should be able to get a fair bit of choice on the NHS.

What you suggested sounds like a good idea too.

My partner is very happy to use condoms or otherwise, he just wants to make sure I feel happy with it, it doesn't mess up my health, and we reduce the possibility of pregnancy as far as possible.

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Heather
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Okay, so with the yeast and the migraines, I'd strongly rule out any of the methods with estrogen.

There is a progestin-only pill, it's called the minipill. It's not as effective as the combined pill, but it's close. It just also has to be taken much more strictly than the combined pill, within a window of no more than the same three-hour period every day. Does that sound like it might work for you? Combining a minipill with condoms is highly effective, and if the condom broke, there would be no need for EC.

You can go back to that BC Bingo page and look up the page on the minipill for more info.

But, we can also talk about combining condoms with natural family planning if you like, or want to avoid any hormones.

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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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-Lauren-
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And I'll add, if I may, that there is a minipill called Cerazette available in Europe that has the same "rules" as regular pills -- since it consistently stops ovulation, you can be up to 12 hours late without compromising protection, similar to combined pills.

It's higher-dose than other progestin pills, but it's a good option for women who just can't take those pills as strictly as required. :)

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pinkskies
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Yes, I haven't had yeast or migraines for a while though. Hopefully they won't return!

Okay, I've found the Fertility Awareness and Minipill page.

I take it this is the bit you're talking about on FAM?

'Couples may also choose to use FAM as a backup method, such as by using condoms as a method of birth control for all times a woman is NOT likely to be fertile, then abstaining completely during most fertile times. This is one way FAM can be an excellent combined method for young women whose cycles are regular, and who don't
want to use hormonal methods.'

My aversion to the pill isn't taking it every day at the same time (I guess that would be easy if I just set my phone alarm!) but the idea of it interfering, whether it be by massive weight gain or my periods suddenly going haphazard, or indeed yeast/ migraine problems. Maybe I'm just being silly though, because when so many women have taken it the chances are it's fine.

Also, would spermicide help much if used over condoms? I thought that might be a good idea, since it serves as a lubricant too. Don't think I've ever seen it sold here though.

[ 06-29-2009, 11:25 AM: Message edited by: pinkskies ]

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Heather
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Just so you're aware, NO pill has been shown to create "massive weight gain." For women using any kind of pill who do gain weight -- and many don't -- on average, we're talking about five pounds, which a) may or may not stick around and b) may also not be about the pill, but eating habits changing with users of the pill. the method most associated with more profound weight gain for some users is Depo-Provera (the shot).

And the yeast issue really isn't one generally associated with progestin-only pills. It's the ones with estrogen where that can (again, isn't always) be an issue.

Spermicides can be another good backup, but it depends on how your body reacts to it. For a decent number of women, it irritates the genitals, and makes them drier and more raw. As well, spermicide can only have a chance at working if a condom breaks, so I'd say that if you think you'd use EC regardless if you had a slip or break, then spermicide just seems like nothing but an extra expense and one more thing to fuss with, you know?

And yep, that's what I was talking about with FAM. If it helps, let me tell you how I use it, as it's one part of my own contraception, even though it's a little complex. For a host of reasons, I can't use any hormonal methods OR an IUD.

What *I* do is combine or alternate FAM, condoms and a diaphragm.

So, I chart (for me, just mucus: I have been charting for years and years, and am not using FAM by itself, so usually skip basal temps unless my cycles start seeming odd per what my mucus tells me). The week around my ovulation, I either just don't do any kind of intercourse and have other kinds of sex, or I use condoms when with ongoing partners. With casual sex or relationships, if I had intercourse during those times, I would usually do both the condom and the diaphragm.

When I am NOT fertile, what I feel most comfortable with is this: condoms up until I get near my fertile time, and then, if I/a partner want a condom break and we're in a fluid-bonded relationship where we've taken care of safer sex, testing, monogamy for the appropriate amount of time, then diaphragm AFTER ovulation. That feels best to me because my fertility is such that my ovulation can move around a little bit, so I prefer to use a method before where a likely failure is very obvious. Not so much with the diaphragm, which I feel better using alone -- if I'm going to -- only when I know I have already ovulated for that cycle and am done with that.

[ 06-29-2009, 12:02 PM: Message edited by: Heather ]

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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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pinkskies
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Okay, sounds like the minipill plus condoms may be a good option for me.

Yeh, put like that I see what you mean. And yes, if there was a condom break I would definitely go for EC. That's why I suggested getting EC incase, and then I would know that it's there and I can use it asap if necessary.

That sounds interesting - I think I'd rather use hormonal methods if possible but from the pages on it it sounds like I'd need to chart it for a while, so for the moment perhaps something else.

I also like the idea of a diaphragm, but I'm not sure I'm going to actually have time to sort this stuff out before I go away. I go away very soon (to say with my partner), since I only met him when he was on holiday here, and then he's been over since to stay with me several times, but obviously he only has so many holidays.

It's frustrating how my doctor was so closed with her opinions and didn't listen last time I tried to get some advice, and how really you've shown me that there are far more options. Maybe the clinic will be helpful tomorrow.

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Heather
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Well, when you go into the clinic tomorrow, my suggestion would be to write down your choice of methods in priority order. Sometimes (while it really shouldn't), going into these visits already knowing some things you may want, and being assertive about that can make a big difference.

Just also be very clear about your health history with them. I'd also be sure to mention what you do or don't want to deal with in a method. For instance, a lot of people aren't as keen on diaphragms because of having to put them in around the time of sex (though you can put them in in advance, just not too much in advance), or because getting them out sometimes may require a partner's help, or because they don't want to use spermicides (which you need to with them).

Obviously, if this is a new relationship, you want to use condoms regardless, so I'd also make clear you do plan to use condoms -- for now, anyway -- and mostly want a backup method you can rely on with as few side effects as possible.

--------------------
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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pinkskies
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They were really great when I went the first time, but I hadn't actually mentioned that I want to discuss contraceptive options with them, I just said I wanted a comprehensive check up of everything that they can test for.

I will write that down though, I think it will help. I definitely want to use condoms anyway, yes, I just also would like a back-up method like you said.

I have noticed that my vaginal mucus does change a lot, and since my periods have been pretty much regular from the beginning, perhaps the FAM method is something I could look into in combination with the condoms. The idea of not having penetrative sex for a week doesn't really bother me too much because there are lots of other ways of enjoying sexual pleasure anyway. [Smile]

I'll write it all down anyway to make sure I can be assertive about it tomorrow.

Thanks for all the help!

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Heather
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Happy to help out! [Smile] Good luck tomorrow.

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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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pinkskies
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Is there a way of working out when I am most fertile easily/ more quickly than within three months, bearing in mind my very regular periods? I've heard varying things about natural family planning and would like to find out more about using this in conjunction with condoms, but I'm not sure where to find information about this in England...
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Heather
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You know, there really isn't.

To accurately predict fertility, you need at least a few cycles of charting to base things on, because you need to be able to see the patterns.

The books we link to in our article on FAM here -- Get With the Flow: All About FAM -- should be available in the UK as well. I know Toni's book, for instance, which is how I first learned way back in the day, is a bestseller internationally.

--------------------
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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KittenGoddess
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Get With the Flow: All About FAM

You can start with that article. If you plan to use FAM, I'd really suggest picking up the book "Taking Charge of Your Fertility" by Toni Weschler. There are a lot of different "versions" of "natural family planning" that people talk about...some of which are not as effective as others. In terms of the most useful version, Weschler's book is pretty much the best discussion available.

You really need to chart for at least 3 months before you can even begin to see patterns. I can say from personal experience that it really takes a good month or two at least before you can easily identify the discharge changes well enough to follow it and match it up with the temping. FAM is also something that you need to keep up with. While previous cycles may allow you to do some predicting, you still have to keep up with your monitoring of every cycle since bodies are not machines and changes are possible.

(Sheesh, my internet is slow tonight.)

[ 06-29-2009, 07:33 PM: Message edited by: KittenGoddess ]

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Sarah Liz

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pinkskies
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I guess if I take the pill though, that's gonna wreck my periods so I won't be able to use this, which I would like to use in combination with condoms... HM!

Right, must stop reading. I'll bookmark for tomorrow, else I won't be up in time for appointment at clinic.

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KittenGoddess
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FAM won't be useful for women on the pill. Since you don't ovulate, there is no fertility cycle to follow.

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Sarah Liz

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Heather
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Nope, you can't use FAM with hormonal methods.

However, if you are using a minipill AND condoms, you really would have phenomenal protection, so a third method in this case -- IMO -- would be overkill.

--------------------
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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pinkskies
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Turns out that the clinic, despite saying they could offer contraceptive advice, don't...

SO... I am going to another clinic later today which is focused on young people.

And added to that, the clinic was pretty bad today. Sort of a 'why bother coming, you have low risk' attitude, paired with general frowning and not very gentle manner. The speculum hurt so much she gave up with it, and then had a sort of 'I told you so' look. Hmph. I think I will go elsewhere in future.

I'd like to use FAM and condoms. I think that would be great, but obviously it takes a while to get there. Since my periods are pretty regular and already I notice quite well when I will bleed etc, I think it would be an interesting method. Would be good to learn more about my body, if that doesn't sound too geeky! [Smile]

Fingers crossed for this other clinc I'll try later!

EDIT: Have just spoken to other clinic who were very helpful, so I'm going down there soon to speak with nurse, and, if necessary, with a doctor. Yippeee!

[ 06-30-2009, 05:47 AM: Message edited by: pinkskies ]

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Heather
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Oh, ugh: the sexual healthcare tours of duty. All too many of us know THAT story. Sorry you've had to deal with that.

Glad it sounds like you may have found a better clinic, though. Fingers crossed!

--------------------
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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pinkskies
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Yup, new clinic is good. Really took into account all my background, family medical history, the problems with the migraines, and the nurse said that whilst she -could- prescribe me something she wants me to see a specialist doctor (tomorrow) to make absolutely sure I get the best option.

Didn't feel rushed at all, which was great, and I felt like she honestly cared about individual circumstances/ needs. She seemed quite wary about any form of pill for me though and she said if I want to do FAM + condoms, there is someone there who could help teach me.

In the meantime though, I need something else obviously, and as I'm also going away soon for a while, it needs to be rather sharpish! [Smile]

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Heather
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So glad you had such a good experience.

In the meantime, my suggestions would be sticking to condoms and getting some EC from them in case, but obviously, just having kinds of sex other than intercourse is also an option.

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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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pinkskies
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As I'm going away for a long time (possibly two months ish) I probably won't be able to start any FAM stuff until I'm back anyway. So I'm going to see what the doctor says tomorrow...

I do enjoy other kinds of sex other than intercourse, definitely (and one of the things I like about the FAM method is the having-a-break from intercourse sort of idea of it), but I kind of want the option now, I'm curious about it... Although I suppose deciding NOT to have intercourse might also be a good idea, and perhaps a healthier option?

One of the other things I found great about the clinic was the nurse explained that even if the EC did impact on depressive thoughts/ phase, the most important thing was that I managed to get out of it. She didn't just focus on the negative things! [Smile]

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Heather
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I'm heading out to an app't, but I don't see why you can't start charting while you're traveling if you want to. It only takes about a minute once a day, and a basal thermometer and a notebook would be all you'd need to bring with you. [Smile]

But for sure, holding off on intercourse if you don't feel okay about condoms alone -- especially while traveling -- is also a totally good option.

Neither is innately more or less healthy than another: it's all about what you feel like is best for you.

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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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pinkskies
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I tried feeling my cervix, to see if I can notice how it's changing, but I'm not sure that I'm feeling it.

I recently finished my period, with monday and tuesday just being the dregs, very very little, almost nothing. When I put my fingers in, it feels like there's something which is quite low and hard on one side of the wall, but then when I move past that it just feels like quite soft tissue, and I can't reach beyond that, even though it's comfortable, my fingers physically can't feel more than that. Is this right? I thought it would be more obvious, but maybe my cervix is too far away for me to feel and what I'm feeling isn't my cervix?

EDIT: have now been to the clinic, and the doctor was great. She said that considering I'm going away in a week (to stay with my partner, he lives abroad but I met him whilst he was staying in England... little added complication), the best option would be the pill because it doesn't need fitting or time before or anything... so I have Cerazette. She said if I get really weird side effects or it majorly doesn't agree then I should feel comfortable to go to a clinic in the other country and get advice, because it -might- have side effects, but of course she doesn't know yet...

and then when I come home, probably in about 2 months, I can try some more options. She suggested some combination of diaphragm or cervical cap + condoms, whilst learning FAM might work, or alternatively the coil, which she seemed to think was a great option, though personally it doesn't appeal massively...

I kind of guessed that she was going to give the the pill, because all the others need time or time and learning... if it doesn't agree with me, I'll just stop having penetrative sex until I'm home again and then we can work something out. But here's to hoping it does!

[ 07-01-2009, 12:22 PM: Message edited by: pinkskies ]

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Heather
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You don't have to feel your cervix to do FAM.

Rather, what you do are: a) take your basal temp each morning at waking, and b) take a swipe inside your vagina with a finger and then take a look at the mucus there.

But just FYI, your cervix juts out into the middle of the vaginal canal, and tends to feel a lot like a nose or a chin with a cleft in it.

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pinkskies
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Will try it after Cezarette trial! [Smile]

And in that case, I think yes, it was my cervix which I could feel.

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pinkskies
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Five days into Cezarette trial, and despite much sleep and relaxing daily activities (like absolutely nothing stressful), I feel sick routinely (I feel sick about once a year generally - an extremely rare thing for me), libido is gone to zero, have lots of stomach cramps, especially when I wake up in the morning, and keep bursting into tears over nothing.

It is NOT going well. Am I best just stopping before it gets into my system even more?

Have spoken to my partner, who is extremely concerned (he mentioned that I was getting upset over really minor issues), and who says he'd rather decide to have no intercourse than this continue or, possibly, get worse.

What do you think? I really wanted it to work, I never imagined I would seemingly get so many side effects within 5 days.

My partner also made frenzy research and got pissed off about there being nothing he could take/use, besides a condom, as a male. Hehe. Made me happy he's always willing to make the effort, it's so not one-sided! [Smile]

[ 07-05-2009, 05:57 PM: Message edited by: pinkskies ]

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Heather
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Actually, side effects from a method are usually the MOST extreme when first starting that method. And it's not really a cumulative medication, like anti-depressants, where continuing to take it means more hormones getting into your system the way you are thinking.

I'd say that if you wanted this as a method, your best bet is to stick with it for at least one, preferably two, pill packs. The effects should decline, not get worse.

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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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atm1
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If you're experiencing really serious side effects, you should give your doctor a call. These may get better in a couple of weeks or after the first cycle, but they do sound severe enough to talk to your doc tomorrow.
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pinkskies
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I only really wanted it until I could get back from being abroad and change to something else. I was thinking 2 months, maybe 3 months absolute max of using it...

It's pretty crappy right now. Usually my libido is high, even if I am a bit stressed (heck, even better, fantastic way to relax...) Ugh.

Very tempted to ditch it, get a book on FAM and a thermometer, and have that. After all, whilst intercourse would be a nice option, it's far from essential.

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pinkskies
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atm1 - I've had a fair few hours sat with a bucket, or having eaten and lurching, feeling like I needed to run to be sick in the toilet. So yeh, they are getting in the way a lot. And what's all the cramps about? I hardly ever used to get cramps. Will give the doctor a ring tomorrow.
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pinkskies
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Spoke to a nurse on the phone, and they just said it's up to me to decide. Either I try continuing, despite feeling like I'm going to puke up all the time, or I stop and either just use condoms or don't have intercourse. Of course, at the moment, I doubt if this continues I would want to have any sex anyway. Hm.
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