Ask Professor Foxy: I Don’t Like Hormonal Birth Control, What Are My Options?

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Dear Professor Foxy,
I don’t like hormonal types of birth control such as the Pill, the ring, or Depo-Provera. Even Mirena is proving to mess with my system too much, so I am having mine removed. But my husband is not a fan of condoms, and after years of not having to use them he’s not exactly chomping at the bit to wrap it up again. We are a committed, monogamous couple so STD protection is not really the issue – we just want to minimize our chances of any unexpected little bundles of joy. He may get a vasectomy in the future, but until then is there a form of birth control we can both be happy with?
Sign me,
Hitched & Horny

Hello Hitched & Horny,
On the fiftieth anniversary of the pill, it seems oddly fitting to write about non-hormonal options. Keep in mind that none of these protect against STDs, so they need to be used in situations where there is next to no chance of catching an STD. Also, I am not a healthcare provider and you should talk over these options with a provider as many of them require a prescription.
You actually have several good options. Mirena (an interuterine device (IUD)) actually releases hormones, but there is actually an IUD (Para-Gard) that does not contain hormones and may be a better option.
If you don’t want an IUD, there are other possible methods though none are as effective as hormonal methods or an IUD. There is great chart from Planned Parenthood that lays this all out. You can also click from this chart to all of the methods I discuss below.
A diaphragm or cervical cap would be my next recommendation. You have to be comfortable inserting it insider yourself and making sure it is placed correctly. In addition, they can make some funky noises during penetration, but that can provide a lovely giggle. You can also use these with spermicide to provide another layer of protection.
Speaking of which, how are you with different kinds of spermicide? Does it irritate you or your partner? The sponge is another good option. No prescription needed, but again you have to be comfortable inserting it. The sponge is back on the market after inspring one of the best Seinfeld episodes ever.
Talk these possibilities over with a trusted healthcare provider and your partner and see which one works best for you. Good luck!
Best,
Professor Foxy
If you have a question for Professor Foxy, send it to ProfessorFoxyATfeministingDOTcom.

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26 Comments

  1. LilyBriscoe
    Posted May 8, 2010 at 10:45 pm | Permalink

    Another good option is to combine fertility awareness (FAM) with barrier methods, if you have the patience/dedication to daily tracking of your cycle, temperature, cervical fluid, etc. I had the same issue with hormonal contraceptives and started FAM after going off the pill for the last time. It’s a nice compromise with my fiance, because we use condoms for about half the month (when I’m potentially fertile) and skip them for the non-fertile days. Another perk is that because I know which days I’m most fertile, we can double up on barrier methods on those days and use a less effective barrier method (i.e. diaphragm alone) on less fertile days. If you’re interested in trying FAM, the book “Taking Charge of Your Fertility” by Toni Weschler will tell you everything you need to know.

    • Posted July 24, 2010 at 11:09 am | Permalink

      YES! I use FAM too and it is an excellent way to use birth control, plus learn more about your body at the same time! I am uncomfortable with most other kinds of birth control, especially pharmaceutical forms because of the big corporations that stand to profit by my use of them and the way that they encourage further alienation from our own bodies (a position that patriarchal culture wants us to be in).

  2. Amie
    Posted May 8, 2010 at 10:53 pm | Permalink

    I was in the same boat, and after a year plus of thinking it over, I went with ormeloxifene, which I order online from India. It is a non-hormonal, once a week, selective estrogen receptor modulator (SERM) which is taken orally. I’ve been using it about a year and a half and so far few side effects (just the occasional hotflash) and no babies. It costs about $50/year. It is not FDA approved, but is sold over the counter in India. For more info, see the links below:
    Mode of action, overview, links to scientific literature:
    http://en.wikipedia.org/wiki/Ormeloxifene
    Dosing details, where to buy, user reviews:
    http://www.aphroditewomenshealth.com/forums/ubbthreads.php?ubb=postlist&Board=4&page=1

  3. paperispatient
    Posted May 8, 2010 at 11:02 pm | Permalink

    Another great resource is Scarleteen’s post on combining contraceptive methods, which you can read here. You can look at the perfect- and typical-use effectiveness rates for basically every combination of methods you can think of. I know of women who aren’t comfortable relying on just condoms, for example, but feel confident combining condom use with withdrawal or a diaphragm.
    FAM is another option that many women begin in conjunction with a back-up method. If you’re interested in it, I’ve heard great things about the book Taking Charge of Your Fertility. It’s not a method that I personally would consider (my periods were extremely irregular before I went on the pill, which fortunately works very well for me). But from my time on VaginaPagina, I know many women for whom hormonal birth control just isn’t right find it a nice change.

  4. jj
    Posted May 8, 2010 at 11:18 pm | Permalink

    @ Amie–If something is acting on the estrogen receptors it IS a hormonal method.
    I have the copper IUD and love it.

  5. linecaro.wordpress.com
    Posted May 9, 2010 at 12:15 am | Permalink

    A really good resource for issues with hormonal birth control (and a whole lot of other issues) is the awesome blog from the society for menstrual cycle research:
    http://menstruationresearch.org/blog/
    another great resource: http://www.sisterzeus.com/directory.html

  6. PaAmbTomaquet
    Posted May 9, 2010 at 2:48 am | Permalink

    What worked for me was VCF (Vaginal Contraceptive Film). It’s a spermicide in the shape of a small square. Just put it in 20 minutes before sex and you can’t feel it! I love it. My only complaint is that you do have to put it in at least 20 minutes beforehand, so it’s something you must plan for.
    http://www.vcf-contraceptive.com/

  7. FrenchKiss
    Posted May 9, 2010 at 4:45 am | Permalink

    Another possibility is sheepskin (gut) condoms, if STD transmission is not a concern. After several years on the pill (and no condom use with my husband) we’ve started using them, and he has to slow down or pull out to keep from finishing too quickly.
    They are kind of weird and rather pricey, but if your only concern is preventing pregnancy (not sexually communicable diseases) I think it’s worth it.

  8. nerdonpurpose
    Posted May 9, 2010 at 11:05 am | Permalink

    My husband and I have been using the old pullin’ out method for about three years, with full success. I have interstitial cystitis, so hormonal birth control and condoms have both caused me trouble. Plus, the husband is allergic to latex. Additionally, this method is free (unless you’re factoring in all the pregnancy tests I end up buying. They’ve all been negative, but I know this method isn’t bullet-proof.)
    This works for us because we’re monogamous, so STDs are not an issue, and because I have a partner I can trust to pull out in time. It’s been great for us, but it’s not for everyone.

  9. Emily
    Posted May 9, 2010 at 1:59 pm | Permalink

    Early withdraw works really well for my husband and me too. We ended up doing it anyway half the time do to preference reasons (I don’t like having my vagina all sticky and leaking fluids for however long after sex, plus does anyone else feel that semen has a uncomfortable, almost corrosive feeling if left too long? Also, I think he likes the cum shot on my belly which is cool with me cause it’s way easier to clean up and he always does it), so when hormonal bc didn’t work out, it was an easy switch. Now I’m on a copper IUD as well and have complications (which I think the severity of my side effects are rare so I definitely think it’s worth a try – if it works out, it’s 8 or so years of hassle free bc), I wish I’d just left well enough alone.
    Anyway, if you trust your partner to always pull out in time, it’s actually a pretty reliable method. Something like 97% accurate with perfect use meaning that the puller outer always does so before ejaculation. It also works great in conjunction with other bc like spermicide.

  10. Gila
    Posted May 9, 2010 at 2:42 pm | Permalink

    Bear in mind that this is another form of nonoxyl-9 (and I’d bet an expensive form, at that), so if you don’t react well to spermicides, this probably isn’t the best BC for you.

  11. borrow_tunnel
    Posted May 9, 2010 at 3:11 pm | Permalink

    On the same note, can someone tell me all the bc methods that require a doctor visit, and all of the methods that are over-the-counter? Please? :)

  12. joanneod
    Posted May 9, 2010 at 3:57 pm | Permalink

    Second this

  13. paperispatient
    Posted May 9, 2010 at 4:18 pm | Permalink

    I just use my vaginal muscles to squeeze out any semen that doesn’t come out when I stand up – it works really well, I just push the semen out and wipe up with tissues.
    For anyone considering withdrawal, I’d recommend starting out with condoms or another back-up method in case there are any errors along the way or if your partner is not good at detecting how far away from an orgasm he is. It’s a totally valid form of birth control, but it’s not right for everyone. My partner can basically decide whenever he wants to come, which is nice, but on the rare occasion I have seen a drop or two of semen (not pre-cum, they taste quite different) come out before he’s close to an orgasm, so figuring out if your partner ever “leaks” semen before he ejaculates is also important.

  14. kisekileia
    Posted May 9, 2010 at 5:59 pm | Permalink

    I would not use something like this without finding out WHY it is not FDA-approved.

  15. flexiblecister
    Posted May 9, 2010 at 7:14 pm | Permalink

    I’ve been considering an IUD for some time too, as I’m often off a couple days either way when I take my ring out and I like the idea of a hands free, hassle free contraceptive.
    One concern is the side effect of cramps. My mother had an IUD when I was growing up and it magnified her cramps to a debilitating level. I’ve always had extremely disruptive cramps — which I why I got on hormonal contraceptives to begin with. Will an IUD inevitably make my cramps come back or do the hormones in ones like Mirena mitigate this factor?

  16. Amie
    Posted May 9, 2010 at 8:23 pm | Permalink

    Technically the definition of a hormone is a compound released by one cell in the body which acts on another cell in the body. The pill contains a synthetic hormone analogs which bind to and act on hormone receptors similarly to endogenous hormones. Ormeloxifene is a small molecule which is not an analog for a hormone and while it works AT the estrogen receptor, it simply alters the manner in which estrogen receptors bind to and interact with estrogen in specific tissues. It does not change the levels of hormones or hormone analogues in the body, thus it is ‘non-hormonal’.

  17. Amie
    Posted May 9, 2010 at 8:47 pm | Permalink

    It’s not FDA approved because it hasn’t been brought to market in the U.S. Bringing a drug to market in the U.S. would probably entail redoing all clinical trials and a ton of money. Pharmaceutical patents work very differently in India, and I don’t think any of the manufacturers there could afford to bring it to US market. Also, because it doesn’t prevent ovulation, only implantation, so technically fertilization could occur, possibly monthly, which is probably too much for pro-lifers to handle.
    In any case, for women in India it is legal, approved and been used for 30 years. The FDA does it’s best to regulate drugs but they don’t always get it right. Heck, Tylenol wouldn’t be approved if it had to go through FDA approval, but it was lucky enough to be grandfathered in.

  18. Amie
    Posted May 9, 2010 at 8:53 pm | Permalink

    Hormones in Mirena can help mitigate cramps. You may be interested in the Gynefix IUD, which is a strand of copper beads rather than a ‘T’ formation, which may help reduce cramping. It’s approved in Canada and parts of Europe.
    http://www.contrel.be/PRODUCTS/gynefix%20info.htm

  19. ElleStar
    Posted May 9, 2010 at 11:34 pm | Permalink

    There is a livejournal community called iud_divas that has a lot of women sharing both their positive and negative experiences with both copper IUDs and hormonal IUDs.
    Copper IUDs like Paragard often have increased bleeding and cramping as a side effect. However, all women react differently to the Paragard. I’ve heard more than one story of women whose periods have gotten less crampy than before they had the IUD. Many others report increased cramping for the first few months, then a return to normal levels.
    A common side effect of Mirena is the thinning of menstrual buildup on the uterine wall. This means that there is less menstrual fluid which tends to mean shorter periods or periods with a lot less bleeding. Furthermore, 1 in 5 women experience a complete loss of their period. I’m happy to say that I’m in this percentage and don’t miss my period a single bit.
    IUDs often have a “settling in” period of about 6 months where women experience random spotting, weird cycles, and random cramping.
    There are, of course, other positive and negative aspects of IUDs. I totally recommend checking out the community. It’s one of the few places on the Internet where people aren’t only talking about whether the IUD didn’t work for them. This has both positive and negative experiences from women.
    On a personal note, I love my Mirena. It’s the best reproductive decision I’ve ever made.

  20. Emily
    Posted May 10, 2010 at 2:23 am | Permalink

    Thanks, I haven’t tried that before. Though I still think I’d prefer not to have to clean up at all since I go through allot of tissue even without a ‘squeeze’ and often I really don’t want to go to the bathroom even for a minute to clean myself as I just want to roll over and sleep afterward.
    Good advise about the leaking caution as well. I hadn’t thought of that. Definitely practice and experience make a difference as there is a learning curve. I think the studies on withdraw effectiveness say that the chance of pregnancy for a couple goes way down the longer one uses this method as those couples who are good at it are golden.

  21. paperispatient
    Posted May 10, 2010 at 11:02 am | Permalink

    It is handy not to have to do all the clean-up – but I always get up to go pee after to help prevent UTIs, so I just take care of it all in one go and then flush everything away.

  22. eliseanne.wordpress.com
    Posted May 10, 2010 at 1:58 pm | Permalink

    Husband and I use a condom/pull out combo method, also because we are both STI free and monogamous, as well as he knows his body well enough and I trust him to pull out in time.
    We go without a condom until he is “getting close,” and then he pulls out and we put on a condom and go back in and finish. That is a good compromise, because he gets to be free w/o it for awhile, and he lasts longer at the end if I need him to. But sometimes we get lazy and just pull out.
    I do have a diaphragm that I use with spermicide. I’ve gotten good at putting it in, but it does turn me off a bit, so then I take longer, but since he is condom-free he goes faster. We need some more practice. But they stopped selling the matching spermicide at Target/Walgreens/Walmart/CVS!

  23. eliseanne.wordpress.com
    Posted May 10, 2010 at 2:12 pm | Permalink

    P.S.
    No one has yet mentioned the other side affects of The Pill or other hormonal methods – depression! I was sent into some bad mood cycles, namely depression, that I couldn’t shake for the life of me when I was on the pill for 8 – 10 months. It all went away like 6 weeks after being off of the the Pill.

  24. queenofbirds.wordpress.com
    Posted May 10, 2010 at 7:44 pm | Permalink

    doctor (or possibly nurse practitioner) visit required: the pill (any kind); Mirena; Paragard; Gynefix; Implanon; Depo; basically any method that is hormonal. Also diaphragm, for the initial fitting.
    OTC or do-it-yourself: condoms (with or without spermicide), Fertility Awareness Method, withdrawal.

  25. paperispatient
    Posted May 10, 2010 at 8:13 pm | Permalink

    The pill affects people so differently – for me, the pill alleviated the insomnia, mood swings, and depression that I suffered from for weeks at a time before my irregular periods. Sometimes trying different brands and hormones and hormone levels can help, but it seems that the pill just doesn’t work for some people.

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