Let's Pour One Out for the Gals Who Can't Find Good Birth Control

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You know who you are. The Pill made ya crazy. Mirena gave you horrible cystic acne. The Patch gave you a blood clot. And so on. So it goes for women who, for whatever reason, just cannot find a good birth control for their particular body and sitch that doesn't make them feel like some kind of shit. This one is for you.


I'm not anti-birth control and am not discouraging its use. I want to use it more than anything! Birth control is an essential part of reproductive health and freedom for women regardless of whether you're preventing pregnancy or just need to chill your periods out, and there are a bazillion options now and that is a wonderful thing. Finding a good birth control is a battle worth choosing. But make no mistake, that fact that so many supposedly great options exist makes it even worse for those of us who have no good luck with any of them.

Of all women of reproductive age, 62% are using some form of birth control, according to CDC statistics (four out of five ladies have tried the Pill at some point or another). But about 30% of women bail on the Pill for one reason or another, 60% of whom cite side effects (see this chart from the CDC concerning women age 15 to 44, from 2006 to 2010, pg. 14). Forty-eight percent bailed on the Patch, and 46% on the Depo shot. These stats don't include IUD use, but one study found that 11% of adult women had an IUD removed. A WHO chart showing cases of discontinuance among IUD users in 14 developing countries shows that fewer than 5% do so, mainly for health reasons.

But, as many of my own gynecologists have told me, there is no perfect birth control, only that which has the least side effects and most fits your needs. And the fact that women stop one method and try several options before settling on the right one is not necessarily a slamming indictment: everybody is different; the odds of a one-fits all birth control method with zero side effects is not realistic; the Pill, and especially IUDs are a great solution for many lucky women, and awareness is increasing.

But what if none of those things works for you? The process of finding the right method can be fraught over a lifetime, depending on your particular situation, partner or partners, your age, whether you're breastfeeding or not, and how the fuck it all affects you. For some of us, it is so annoying and exhausting and time-consuming and wait-and-see and historically expensive, and even then you can still not always land on the right thing.

The whole appeal of birth control is obviously 1) not getting pregnant and 2) not having to think about not getting pregnant. But nothing has been a good fit for me so far for a slew of reasons, and pardon me for saying so but if your boobs constantly ache, you walk around in a weird fog, feel crazy, or are bleeding heavily, how much not thinking about it are you really getting, all said? In some cases, for all the set it and forget it, you're thinking about the side effects a helluva lot more than you're thinking about sex, the thing you want to be able to do without sweatin' it. And here's the worst part: Some of the side effects make you not want to have sex anyway, like lowered libido or wicked hot pulsing acne on your chin times one thousand.


Now I shall anticipate your arguments:

Anticipated Argument #1

I use X thing and love it with no problems! Don't see what the big deal is! You're just a whiner!



I am so happy for you I could vom because of jealousy. But I am writing in communal sympathy for those of us who have discontinued method after method looking for the right thing, that perfect blend of doesn't-jack-my-shit-up but gets the job done. The Goldilocks of birth control.


Anticipated Argument #2

THE IUD TRY THE IUD! Mirena has lower side effects than the Pill! And ParaGard is copper and has no hormones at all! And the new Skyla is for women who've not had a baby!



I hear you. My friend is a nurse practitioner and says Mirena is the method she recommends the most. My own gynecologist recommended it to me when I asked for the lowest-impact side effects with max efficiency and least required interaction. Because I already have heavy bleeding, we opted against the copper IUD, which is hormone-free, because it can cause even heavier bleeding. If I am bleeding every day or more than now, which is already too much, you better believe I won't get pregnant because I will not be having sex ever again, so how about I use nothing, feel great, and never have sex?


But Mirena didn't work for me. I bled for three months (which was actually fine since I expected it would stop and then I'd be period-free, which happened) but I had increasing headaches, fatigue, and wicked wicked terrible acne that made me not want to leave the house ever again or do anything because oh my god my face is alive and burning.

Anticipated Argument #3

Yeah, acne sucks I guess, but does it suck worse than an unintended pregnancy?

– someone without permanent hormonal cystic acne on their chin


Not a fair question. Birth control is going to come with some side effects, but the point is, everyone should to be able to find one with the lowest risk. Which is why this bit of advice from a HuffPo piece about things you should know about birth control really stuck with me:

All brands of the pill are equally effective at preventing pregnancy, but that doesn't mean they're all equally well-suited to you and your body. And for a lot of women, the onus is on them to figure out what is best." Gynecologists will prescribe the pill they have the most experience with or the one they currently have free samples of in the closet," Dr. James Simon of the Women's Health Research Center in Laurel, M.D., told Women's Health.

If you're having side effects that you think might be related to your birth control, try tracking them in your calendar and taking that information with you to your next appointment with your gynecologist. It'll help your doctor or nurse get a sense of what you're experiencing and guide them toward better options for you. Some side effects may go away after your body adjusts, others may not. But you shouldn't have to settle for discomfort.


That bolding is mine, because I ask sincerely, exactly how much discomfort are you willing to endure? Not worrying about pregnancy is great, but not if I must spend every day feeling ravaged by hormones. That can affect not just your vanity, but your day-to-day existence, you relationships, your confidence, your fucking face.

So to all the women who had terrible times on birth control, who tried to tell your doctor it made you feel awful only to have them tell you it was all in your head, who still seek an answer that may never reveal itself, I got you. I feel you. We may be statistically insignificant, but we still matter, dammit!


And seriously: If you are out there looking for a new method and want to research the various options and their effectiveness and convenience, let me point you to the same terrific, well-designed site my gyno told me about, Bedsider, which allows you to specifically review methods by desired feature, like hormone-free, party-ready, STI prevention, or "do me now."

And for the rest of us: One day! One day for all of us!

Illustration by Tara Jacoby.



Ladies, if this post resonated with you, go out and borrow a copy of Toni Weschler's "Taking Charge of Your Fertility." Or download the app called Kindara. Or just Google "fertility awareness method." No, it's not the same thing as the "rhythm method."

It does take work. You measure your basal body temperature first thing every morning and write it down or punch it into an app. You should also check your cervical mucus daily and chart that. For extra safety, you can monitor the shape and position of your cervix. After a couple of months of charting, you should be able to tell what day in your cycle you ovulate. Then you avoid having unprotected sex during the "fertile window" leading up to and including ovulation.

Like Tracy, I've anticipated your arguments. No, this method is not foolproof. Yes, you need to have predictable cycles without hormonal birth control. Yes, it takes work. No, it's not for everyone. But if nothing else has worked for you, and you're interested in learning a TON about fertility and how your body works, you might want to at least look into this and see if it might be for you.