I’ve already shared in a previous blog about my ups and downs (mainly downs) with the pill. I talked about trusting God even in the midst of a hormonal storm. You can check it out here. However, even in learning to trust God through it all, I still had to get off the pill, and my husband and I still did not want to get pregnant. At the time, I thought it was impossible to have reliable birth control without using hormones. When I got off the pill, I resigned myself to the fact that I would get pregnant within the first year of marriage.
Let’s face it, when you go to the doctor for your pre-wedding visit and say, “Give me birth control, I don’t want to get pregnant,” she’s going to give you the most effective option so that she’s not the same one delivering your newborn triplets nine months later. It’s very rare that your OBGYN is going to sit you down and discuss the pros and cons of all contraceptive options. She’s going to write you a prescription and say, “Take it everyday. When I see you next year, you won’t be pregnant!”
Who can blame her really? The pill and other hormonal options (patch, injection, implant, Nuva ring, Mirena) work for a lot of women. But as I came to terms with the fact that I would never be able to use hormonal birth control, I realized that I was far from alone. I talked to several women who could not be on hormones for one reason or another and I realized that I had more options than just hormones or pregnancy.
I want to lay out some of those options. In figuring out my birth control situation, I have done hours upon hours of research on non-hormonal contraception. I have researched not only what the companies say, but what real women have experienced using these different methods. My goal is to condense what I have learned so that I can maybe save someone else hours upon hours of research.
1. Keep in mind, this will not be scientific or unbiased. I’m not coming presenting a medical standpoint and what I say should not take the place of what your doctor says. I will be sharing my own thoughts, opinions and findings on all things non-hormonal.
2. I will be very straightforward and detailed in talking about birth control and certain issues dealing with sex. I have done my best to make sure everything I say is appropriate, but I still wouldn’t recommend this blog for the squeamish or for a younger audience
That being said, there are a couple of things that need to be defined that I was clueless about prior to all this research.
The Pearl Index: When a company says that their form of contraception is 99% effective, they are referring to The Pearl Index. 99% effective does not mean that it works 99 times out of 100. It means that if 100 sexually active women use this contraception like they are supposed to for a year, only one of them will get pregnant in that time span.
Perfect use: This shows what the Pearl index will be if you use the contraception exactly like you are supposed to every time: not missing pills or temperature readings, inserting everything right, putting it on right, and not being stupid. This often skews the pearl index to make it look better than it is, since almost no one uses everything perfectly all the time.
Normal use: If contraception you are looking into cites a normal use percentage, look at that instead of the perfect use. Normal use factors in common mistakes, the risk of something going wrong, etc. Perfect use shows the ideal, normal use shows what is likely.
Cervical cap – A flexible cap that is inserted before intercourse and left in for eight hours afterward. Covers the cervix, which blocks sperm. Usually used with spermicide. (Cost: $89/year + doctor’s visit)
Diaphragm – Similar to the cervical cap, but dome-shaped with springs to make it fit. Covers the cervix, blocks sperm. Usually used with spermicide. (Cost: $15-50/ year + doctor’s visit)
Condoms – I don’t feel the need to explain what a condom is. (Cost: Approx. $20/36 pack)
A lot of us probably think that condoms are the end all. That condoms mean no fun during sex and an automatic pregnancy. That isn’t really true. Condoms and other barrier methods can be effective contraception and do not take all the fun away. Barrier methods are the most widely used form of contraception, they require no daily or weekly schedule, and there’s no risk of the side effects that come with more invasive birth control.
Companies that sell condoms, cervical caps and diaphragms are going to say that they are anywhere from 92-98% effective (depending on which kind you use). Keep in mind that is perfect use and no one is going to use a barrier method perfectly every time. Besides all the mistakes that you and/or your husband can make in just inserting it or putting it on, there’s always the possibility of something slipping, coming out, breaking, etc. It’s not hard to see how this could happen, you are moving around quite a bit.
Normal use for all of these methods is somewhere in the 80% range. Still not bad odds, especially if you consider yourself to be a little more careful than the average bear, but not exactly fool-proof. A few other cons that come into play are possible allergic reactions or other slight irritations and pains. Another common objection is that barrier methods tend to interrupt sexual spontaneity, or that either spouse might feel it during sex.
Just a few thoughts on improving the effectiveness of barrier methods. First of all, learn how to avoid some of the most common condom mistakes here. Also, consider using spermicide, foams, jellies or film in addition to your barrier method as a safeguard. The more protection you use, the better.
Bottom Line: Barrier methods are not a bad option if you are looking for simple birth control with virtually no serious side effects. If you are careful, barrier methods can be pretty effective without taking all the fun out of sex. However, it is not much of a long-term contraceptive solution. If you are very serious about not wanting kids for a set amount of time, this is probably not the best option.
Cost: $400-$700 one time. (Varies based on insurance and doctors. Insurance often covers it. Payment plans are also usually available.)
Before all my birth control research, I only thought of an Intra-uterine devices as the t-shaped thing I saw on commercials that I was never ever going to let anyone stick inside me. Honestly though, I think the fear factor for IUD’s is taken out a bit when one really looks into them. There is a hormonal IUD called Mirena (which has many of the same side effects as other hormonal birth control) and there is a copper IUD called Paragard, which is completely hormone free. Paragard is placed in your uterus and changes your uterine lining to immobilize sperm. Simple enough, right?
Paragard is inserted as an outpatient procedure in the same little room you have your annual in. From what I’ve heard, it is fairly simple procedure, similar to tampon insertion. After insertion, you can keep the Paragard in for up to 10 years with no risk, but can also have it taken out at anytime with no risk. In this time, you have to do a simple monthly self check to make sure it is still in place, but there is really no other routine or hassle with it once it is in. Another plus is that there is not really a difference between perfect and normal use. It is 99% effective, and as long as the doctor inserts it right and it stays in place, there’s not much of a chance you can mess it up.
On the downside, there is almost a guarantee that there will be pain involved for the first few months. Most women report an intense and sharp (but brief) pain during insertion, and heavy periods, cramps and abdominal pains during the first few months. The level of severity varies from person to person, but almost all women experience pain at some level. Fortunately, almost all women report it subsiding after three months or so. Another thing to consider is that women who have not had children are generally not encouraged to use an IUD as the risk of expulsion is greater. (A.K.A. severe cramping as your body is trying to expel the foreign object.) There are a few other very rare but serious side effects that you can read about on the Paragard website, which is cited below. One final down side that I only recently heard about is an Ethical Consideration connected with Paragard. I will save the space and not explain the details, but if you believe that life begins at conception, you will want to check out the linked site.
Bottom Line: If you’re willing to risk the pain for a little while, Paragard is a very effective and worry-free option. Research everything and talk to your doctor for her thoughts.
Natural Family Planning:
Cost: Dependent upon thermometer choice
I really respect people who use natural family planning. It takes diligence and discipline and knowledge of your own body. In case you are not familiar with natural family planning, the idea behind it is that you are only fertile for a few days every month: the day you ovulate, five-ish days before (because of the lifespan of sperm), and maybe a day afterwards (because of the lifespan of an egg). The idea is that your body sends off signals during the time that you are fertile, so through tracking those signals (taking your basal body temperature and observing cervical mucus), you can find out when you’re fertile and either abstain from sex those days or use back up contraception.
I guess NFP kind of has a bad reputation, mainly because of the couples that are not very disciplined in it. NFP can be very effective when both the husband and wife are diligent with tracking and willing to back off during fertile days. Just how effective NFP is hard to tell, since there’s a broad spectrum of how diligent you can be with it. The numbers I’ve seen put it about 80% effective normal use, right around the normal use of barrier methods. Not bad. Added pros: there is nothing unnatural in your body, no side effects, you’re much more aware of your body and cycle, and you are very aware of when you are fertile for when you decide you want to get pregnant.
For NFP to be remotely successful, however, you must be disciplined. It requires a daily schedule and charting first thing in the morning and also abstinence or back up contraception during fertile days. There’s also a lot of guesswork involved and there is, of course, room for error no matter how careful you are.
Bottom Line: If you are self-disciplined and good with routines, this could be a good option for you. Your body will love you for keeping everything natural. Just like barrier methods however, if kids are out of the question for you right now, look into other methods.
Ladycomp (cost: $485 one time, payment plans available)
Pearly (cost: $330 one time with a $35 battery replacement charge every 2-3 years, payment plans available)
Fertility monitors like Ladycomp and Pearly are natural family planning handheld computers. When I first heard of them, I thought they sounded a bit sketchy, however, when I researched them I found that they basically had all the pros of NFP and took away several of the cons (effectiveness rate is much higher and it takes a lot of the guesswork out for you). These two sister products are built with highly sensitive thermometers and are pre-programmed with thousands of women’s cycles and temperatures. Just like with conventional NFP, you take your temperature every morning, and based on your temperature and where you are in your cycle, the monitor gives you a red or green light (red meaning you’re fertile, green meaning you’re not, so go!) From there, it’s just like NFP, choose to abstain, or use backup contraception when you’re fertile.
I already said this blog would not be unbiased, so I’ll go ahead and tell you that I use Pearly and although I haven’t been using it very long, I am very satisfied. I don’t have anything unnatural in my body, there are no side effects, it requires minimal work, and is still very effective. Perfect use for fertility monitors is in the 99% range, but it’s hard to know the normal use, since one can be as diligent as she wants. However, as long as you’re taking your temperatures in the morning and doing what the monitor says, there’s not much room for error. Just like conventional NFP, added bonuses are being aware of your cycle and the fact that it can aid you when you do want to start a family.
The biggest downside of a fertility monitor is having to trust your contraception to a computer; the idea took a long time for my husband and me to get used to. There is also the matter of routine and diligence — taking your temperature first thing every morning and taking your monitor with you if you ever go out of town, etc. And, since it is natural, you gotta stick to abstinence or reliable back up contraception when you’re fertile.
Bottom Line: I found a fertility monitor to be the most effective option with the least side effects, so if you’re looking for non-hormonal contraception, they are worth checking out. However, if you have an erratic schedule, can’t do routines, or are freaked out by a computer keeping track of your fertility, a monitor may not be right for you.
BOTTOM, BOTTOM, BOTTOM, LINE: There is merit to just about all forms of birth control and one kind will not work for everyone. You may not be into hormonal, you may not be into natural. You may have a crazy schedule or hate routines or have an extremely low pain tolerance. Kids may seem like an impossibility right now or you may be getting ready for them. Keep all these factors in mind and explore your options. Be careful whose advice you listen to and find the birth control that is best for you and your husband.
Information on all types of birth control
Cervical cap website
Information on diaphragms
More Paragard reviews
Information on Natural Family Planning
Lady Comp website
Pearly/Lady Comp comparison
Customer Reviews for Lady Comp