Thursday, September 07, 2006

Advice: I hate condoms! (Who doesn't?)

Hey Go-To Girl:
My partner and I have just started to have sex without condoms, but I'm not on birth control. I'm
wondering what my options are, because I'd like to continue not using condoms, but am also under the impression that unless I want a baby that using nothing is about the dumbest thing EVER (any thoughts on that are appreciated, too, because for some reason he's not as worried about me getting pregnant...and I'm definitely open to the possibility that I just don't know too much about this).
Anyway, I'm really NOT wanting to use highly hormonal birthcontrol, and a midwife friend of mine mentioned a few weeks ago about a kind that is mild but effective, and that you insert/replace once a month.
Does that sound familiar?
Whatchu got for me gal?
Wants Total Freedom

Dear WTF,
You're right: using nothing is the dumbest thing ever. I won't address my feelings about your partner who seems unconcerned about you accidentally winding up pregnant (but where I come from, we have a word for a guy like that...) but here's the lowdown on condoms and nonhormonal methods.
a) Have you been vigilantly tracking your menstrual cycle for the past year and found that you have a predictable, regular cycle?
If the answer is "no," don't pretend that you understand the Rhythm Method and can decline to use condoms at certain times of the month. While the chances of getting pregnant during certain phases of the cycle are remote, finding out you're pregnant is a bad way to retrospectively predict when you ovulate.
b) Have you and the guy had the STD conversation?
If the answer is "no," you should be using condoms even if you're sure you can't get pregnant.
c) I hate condoms, too. A lot. That's why I got a ParaGard IUD.
The upside: It's nonhormonal and more effective than sterilization (seriously). It lasts 10 years (seriously). None of that weight gain/depression/moodiness/lack of libido/generally hating everything that you get with the Pill. It's the most popular contraceptive method both worldwide and among women OB/GYNs.
The downside: Cramps are worse, and my period lasts a bit longer. If you have bad cramps now, getting an IUD will make them worse, perhaps even debilitating. But if you don't (I had no cramps before my IUD) then it won't be that bad.
d) The once-a-month method your friend mentioned is the NuvaRing, which is a ring that you insert into the vagina each month. It releases a lower dose of hormones inside the body, so the side effects are supposed to be milder than with other hormonal methods. From people I know who have used it, they report high levels of satisfaction and nobody's partner has, um, felt it up in there. But if you're anti-hormones over all (as I am) then it's a no-go.

If you've used hormonal methods before, any side effects you experienced are likely to return. Some MDs are hesitant to give IUDs to women who haven't had children, but I've done the research and, trust me, if you're STD free you can get one.
If you have any STDs, you shouldn't get an IUD, because having an IUD and an STD can blow up your risk of pelvic inflammatory disease, which can cause infertility and death. But the IUD by itself DOES NOT cause PID or infertility. Nurse Midwives are also able to insert IUDs as long as they've been trained to do so and I prefer them for Gyn care in general.

To sum up: buy a box of condoms, and use them until you get your shit together. My favorite are Kimono MicroThin.


For more:


Gavin said...

Hi there GTG!

Glad to see your new blog - looks great.

Before I share this story, let me say that I am truly a fan of the NuvaRing - it is a no-nonsense, easy-to-use method that delivers a low dose of hormones right where they're most needed. As you say, it is totally ineffective in the prevention of STDs (unless you consider children to be members of that category - which I don't).

You say "nobody's partner has, um, felt it up in there" - by which I assume you mean that no man has reported to you, directly or via his partner (or, I suppose, via the grapevine), having felt the NuvaRing inside his partner during intercourse. I have.

It's not unpleasant, and can even be a little stimulating. This is, of course, easily avoided, in a playful move that turns NuvaRing into c**kring. Either partner can easily (and gently, guys!) reach "up in there", catch the ring with a finger, and (assuming the man in question is not monstrously huge - it's a slightly stretchy ring, and several inches in diameter) drop it over the top of a nearby penis. That can be as stimulating as you want it to be, or not. The guy is not likely to forget to return the ring, which is designed to be left out for some small number of hours per day. Hours. If you're sleeping with a man who might just leave without returning the ring, you need to a) go back to condoms, b) ditch the loser, and c) get tested for STDs and pregnancy.

Another benefit of the NuvaRing - as with other hormonal methods, it is possible to skip your period for months at a time, which some studies suggest may be linked with lower incidences of some types of cancer. I seem to recall breast cancer, ovarian cancer, and cervical cancer, but I could be wrong. (I read about those studies in connection with an article on the development of a contraceptive nasal spray, which I won't go into here.)

Thanks again for starting the blog - it looks like fun reading!

Go-To Girl said...

Hi Gav! Thanks for reading. And what a fantastic "off-label" use of the NuvaRing! I love it.

Inez said...

The main reason some doctors are hesitant to put an IUD in a woman who hasn't been pregnant is because a woman's uterus permanently stretches a bit after pregnancy (go figure). Pre-pregnancy, some women's uteruses are too small to comfortably house an IUD. By "comfortably house" I mean not go into uncontrollable spasms (think: really really really bad cramps) trying to push the foreign object out. There's the cervix, and then above the cervix there's another tight spot: if the distance between the 2nd tight spot and upper wall of the uterus is less than 6 cm, an IUD is a no-no. Your doctor can measure your uterus-- it's not pleasant, but it's not a huge deal. No worse than getting an IUD put in, I would imagine.