Overwhelmed by Birth Control Options

[Keely869667]

Hi there - I definitely suffer from health anxiety, but lately I’ve been having really obsessive thoughts about trying to figure out what kind of birth control is right for me. All the options seem *not great* but as I get closer to getting married and wanting to have sex for the first time (I’m 23), I know I need to have some sort of reliable birth control because I definitely don’t want kids and am absolutely terrified of being pregnant (I’ve had tokophobia pretty much my whole life). I tried a couple different brands of the pill and didn’t like the mental side effects (crying and mood swings) from them so I quit them each after about a month. My doctor recently prescribed me a different pill to try but I’m afraid to take it. I know you’re not supposed to, but I read a lot of negative reviews and side effects about various birth controls online and it seems like every option could have pretty significant side effects. I can’t stop scrolling through Reddit comments and medical forums looking for the seemingly perfect birth control option for me but I just feel overwhelmed and stuck and I can’t decide on anything. I would be okay with the pill if I could find one that doesn’t mess with my moods too badly, but I’m afraid of the increased risk of cancer or blood clots. I was considering the copper IUD, but I’m scared of painful insertion and possible pain/bleeding afterward. Condoms and Phexxi gel is my third option but anxious that they aren’t as effective and are annoying to need to use each time. I really want to get my tubes tied but because of my age doctors are hesitant to do it and my fiancé isn’t crazy about that idea since “I might change my mind” even though right now I don’t think I ever would. I’ve talked about all this with my doctor but she’s kind of left it up to me saying it’s my body and I have to choose the BC method I’m comfortable with but I just don’t know! I think I’ve grown up with a lot of negative messaging surrounding birth control but I have friends who use different methods and they seem fine. Yet I can’t stop searching for side effects and user stories online and worrying that every bad side effect will happen to me. I came across this website and was hoping you could point me in a positive direction, thank you!

[Andy]

Hi Keely869667,

If having accurate, fact-checked information about birthcontrol methods organised in one place would be helpful, you can check out our Birth Control Bingo!

What can also be helpful to keep in mind is that no medication or treatment is perfect for everyone, our bodies are really complicated and diverse so when you try the same thing on many people, which is what is happening during medical trials, some bodies can react differently that most and in a few cases (otherwise the medication/treatment wouldn’t be approved) the reaction can be a unpleasant side effect. So instead of “this will happen to everyone because they tried something” it’s more like “this happened to a few people when trying something”. Additionally, people who come speaking about their experiences online are way more likely to be those who had negative experiences and feel the need to vent about it rather than those having a good time with a given method, so again, what you see online might not reflect the reality.
Secondly, what might alleviate the pressure to choose the best form of birth control right now is knowing that they are not permanent, you can try one and if it won’t work for you try another until you find something that works for you. It may take some time, but sometimes it is the only way to find out.

As for the pill your doctor prescribed you, would you feel comfortable discussing your concerns with them?

[Heather]

I want to add a few things to what Andy said for you, Keely!

1) The worst side effects of any hormonal method (and most medications) are in the first few months. So, by starting and stopping two different methods you only used for a month each, you kind of guaranteed you'd be hit hard by side effects and without the time needed to see if they let up.

2) Unless you think your doctor isn't a good provider, they checked your health background before choosing to prescribe you the pill. If they would have thought that it would have posed risks of things like blood clots, they would not have prescribed it for you: people who get blood clots from hormonal methods usually do because they are already part of their health or genetic history.

3) Hormonal methods are actually associated more with cancer PREVENTION than with cancer risks. But if you're just wildly googling, rather than reading actual, credible studies, you're much more likely to find inaccurate information, things like conspiracy theories or people's anecdotes that may or may not have any actual basis in reality or truth.

Lastly, I have done one-on-one BC consults for people for many many years now. Birth Control Bingo, the link Andy shared with you, is something I created based on doing those consults. Why don't you walk yourself through it, then circle back here and you and I can talk about what methods you found by going through that resource (there's a series of questions and answers: just keep clicking through based on your answers) and see what might feel like the best fit?

[Keely869667]

Hi - Thank you so much for your response and for serving as a sex positive resource! I've gotten an ultra low-dose combo pill prescribed by my doctor that I've been taking for a couple days now. I haven't really noticed any side effects so far other than some trouble falling asleep which I think is related more to my anxiety ABOUT taking the pill rather than the pill itself (used to have really bad insomnia and anxiety/depression before starting antidepressants). I know I need to give this pill at least a few months to decide if it will work for me, so I'm trying to manage my anxiety until I can get to that point. I'd consider the copper IUD if this doesn't work out to avoid hormones if it turns out they don't work for me, but nervous about it making my currently pain-free periods more painful...

[Keely869667]

I am also considering condoms plus the new Phexxi gel that has been recently released - condoms initially made me nervous because of the higher failure rate, but what is the failure rate of condoms combined with Phexxi used every time I have sex? Is it closer to that of the pill?

[Sam W]

Hi Keely869667,

I'm glad the pill is working for you so far! While it's good that you have a plan for what method you'll look into if the pills turn out not to be a good fit, for now I'd just focus on seeing how the next few months go, rather than jumping straight into worrying about the potential side effects of the copper IUD.

As far as condoms go, it actually looks like Phexxi has the same typical use effectiveness--in other words, the effectiveness that tends to exist over the course of a year in the real world--as condoms do, and it actually has a lower perfect use effectiveness. Looking at the numbers available, it looks like combining the two would put you at about 98% effectiveness with typical use, which is pretty dang good.

I will also say that while condoms can and do fail, they're also really, really effective when used correctly, and those failures tend to be way more about user error than the condoms themselves; not using them for all activities that pose a pregnancy risk, putting them on the wrong way, not using enough lube, things like that. Too, they're still the only pregnancy prevention method out there that also protects against STI transmission, which is why we tend to encourage people to use them even if they're on another effective birth control method. Plus, combining them with another method not only increases the amount of pregnancy, it can also help people feel less anxious overall because they know that if one method does fail, the other method is still in place.