Saturday, January 8, 2011

Starting on The Pill Later in Life

I am one of the only American women I know who has never taken any form of hormonal birth control. Until now, it had never felt right for me and my body, and I have a hard time articulating why. I know full well that it currently is and historically has been such a good fit for like pretty much everyone and their mom, forever. When I was a teen, my own mom (a relatively asexual being whose DH had a vasectomy right after I, their only child, was born) kind of sort of discouraged it with a couple of hints and some shoddy reasoning, while stopping short of having an actual birth control conversation with me - she's skilled at odd verbal acrobatics like that. In hindsight, I think she just didn't want me to ever perceive that taking the Pill would give me carte blanche to bed whomever free of consequences, because obviously it offers no protection against STDs. I think she thought somehow I wouldn't understand that basic scientific truth (duh, right!). Luckily I was resourceful and got my hands on the right books, and finally found The Bible on such matters: "Taking Charge of Your Fertility" by Toni Weschler. It seriously should replace the textbook for young women in junior high & high school sex ed classes. Can't wait to introduce it to my DD someday. I seriously credit this book with singlehandedly having helped me avoid unwanted pregnancy, because from it I learned all of my fertile signs by heart years before I officially needed to know them to start trying to conceive, and was basically using Fertility Awareness for years as a back-up to the various barrier methods I was using.

Another reason I missed out on the ritual of taking the pill during my "peak" fertility window of ages 18-35: I was a dork who starting having sex relatively late in college, at least when compared to my peers, so my need for reliable birth control was low. So a supercheap diaphragm, some spermicide, and a box of condoms pretty much got me through the 90s. I was working too hard and not having nearly enough sex. Meanwhile, nearly all of my closest friends who had started taking The Pill when they were between the ages of 16 and 18 pretty much stayed on it until well after age 30 when they started trying to get pregnant. Most had great, acne-free skin, and no trouble eventually conceiving. The only real negatives I ever heard about The Pill were breakthrough bleeding on occasion, and also the reports from three of my friends who suffer from migraines who were finally years later told by doctors "you should have never been given this kind of pill!" and who were then thankfully cured of their headaches once they switched to a different formulation.

Fast forward to the present day: this is my 35th year on the planet. I'm done having kids. I don't want to get my period anymore, and I would like the acne on my back to clear up. So yesterday I filled my first prescription for The Pill. It seems I am about to join the proverbial club. That said, the original plan was for DH to get a vasectomy - BUT as there unfortunately is no longer the local urologist who could do the 'no needle, no scalpel' technique here in Podunkville (good doctors don't stay here long) DH will have to wait until we have a couple of days free to get it done in a bigger city - so that means realistically it could be a few more years. I suppose I could have forced the issue and made him go see a local non-specialist who might eff up his junk, but honestly that's not the choice I would make for myself if I were in his shoes, obviously!

I guess my only question is, assuming The Pill works well for me and DH never gets a vasectomy, at what age do I eventually stop taking it? 45?? 50?? Or even later?? Hmm... My doctor didn't satisfactorily answer that one.

Ok, it's pithy link time. I'm sure most of you have already read or heard about Vanessa Grigoriadis' recent piece on "Waking Up From The Pill" - but if you've been living under a Cheerios-scented rock like me, maybe not. You can find it here. Recommended reading, though I have some issues with some of the assumptions she makes.

Your thoughts? What pill are you poppin'?


Jac. said...

Very interesting article. I am one of those ones on the pill since 19. When I went off the pill to try to get pregnant the first time it was like I came out from a fog and I realised that for YEARS being on the pill was suppressing my libido and lowering my energy level. So after DS I got an IUD (the paraguard - non-hormanal). Now I don't know what to do. DH and I are in discussions for him to have a vasectomy, but I think it will take a few rounds of "negotiations" and probably me booking the appointment before that happens. I didn't mind the IUD except it's not fun to get inserted and I had slightly painful periods. So I don't want to go through that if DH will get the vasectomy, but what to do in the meantime? I really don't want to go back on the pill. Maybe if we just don't have sex for long enough, that will motivate DH to get the vasectomy.

I was on ortho-tricylen. Aside from the low libido and energy, I did have great skin :)

blue said...

I have no idea when people should stop taking the pill. After having kids, my doctor didn't want me to go back on pills, but I think that recommendation varies for different women. I would definitely try to get a better answer out of your physician at some point. I know there are some docs who believe women shouldn't take it for more than a certain number of years but I don't know what that information is based on.

I, like you, was a late bloomer in the sex-having category. I took an ortho-try pill from about age 22-28. I did have better skin, but I don't think it affected my libido at all. When I went off the pill at 28 I got pregnant immediately and intentionally. I'm working on my second Merena IUD and I like it a lot. Very little bleeding, bloating or cramping during periods. The only down side is that DH can occasionally feel the threads that are near the cervix. We were intending on doing the vasectomy route, but the benefits to me with the IUD are awesome and I'd rather just keep it for now.

Good luck!

MrsHaley said...

I was on the pill from age 18-28. I went off after I got married and was ready to have kids. I also felt like a fog lifted once I came off it -- not to mention that it was making my migraines 10000% worse, which was a conncetion nobody ever made.

Between children, I used a diaphraghm and actually liked it a lot. Now that we're done having kids, DH got the vas. Our youngest was born in Sept. 08 and he got snipped in May of 09.

TBH, the vasectomy really made a difference in our sex life, because now there's not even a thought of getting pregnant ... before that, pregnancy was ALWAYS in the back of my mind each time I had sex, regardless of how effective the birth control method might have been.

So, in my experience, the pill was wretched and the vasecotmy is great. Sorry that's not much help, Hush.

Cloud said...

I was on a standard combo (estrogen + progesterone) pill for years. I went on it in high school, before I was sexually active, to control really bad cramps. And it worked. I never had any unpleasant side effects from the combo pills, although I did have to switch around a bit to find one that wouldn't give me break through bleeding.

After Pumpkin was born, I went on the mini-pill (progesterone only), and coming off that WAS an eye-opener. It was like: "Oh! There is my libido! I thought it had disappeared into a sea of poopy diapers and sleepless nights!"

So after Petunia was born, I got an IUD. I got the Mirena because I was lured by the idea of not having a period at all. But that's not what has happened to me- I've had lots and lots of spotting, and the occasional heavy period. I haven't figured out any cycle at all, and the cramps associated with the occasional period and some of the spotting are pretty bad. AND I think even that low level of progesterone is doing a number on my libido. So let's just say I wish I'd gone with the Paraguard!

I'm basically waiting to see if things get better after I wean (I've heard that they might), and if they don't, I'll have it taken out early and do something else. I'm not sure what- I could try the Paraguard, but I had a strong vagal reaction when I got the Mirena in, and am in no rush to repeat that. Hubby isn't on board with the vasectomy idea, so I may just got back on a combo pill. We'll see.

Cloud said...

Oh, and I had zero trouble getting pregnant after coming off the pill. It took two cycles the first time, and one (yes, one) the second time. I had a rough idea of when I was likely to ovulate, but we didn't really worry about it too much.

I guess that tells me I had better be careful about birth control, because if we aren't using it... I'm probably going to be pregnant.

Jac. said...

PS - meant to add that my mum (just turned 50) is STILL on the birth control pill and her doctor told her that was fine. She's been on it since she was 18. Funny story - she lives on a third world island and a few years ago the island failed to receive its shipment of birth control pills for about six months. My 47 year old mum actually had a pregnancy scare. We were very nearly the family from Father of the Bride 2 where the mum and daughter were pregnant at the same time. I try not to think about the fact that this means my parents are still having sex, because I am still really immature like that.

PPS - Timing is impeccable - DH just came home from the drugstore with a box of condoms which is HILARIOUS because it means he thinks he might get laid sometime soon (NOT) and wiggle out of the vasectomy discussion.

Melba said...

I've been on cyclen (an estrogen/progesterone combo pill) since my late teens. Then went off it at age 29 to get pregnant, and the only change was that I immediately broke out in acne. It sucked bigtime. Three months later, I got pregnant, and the acne persisted throughout the whole thing. I had major problems breastfeeding Rosie, so by the time I was willing to let my husband touch me with a ten foot pole I wasn't breastfeeding anymore and just went right back on the same pill. Acne went away.

Then I went off it again when I was ready to start trying to get pregnant again, and conceived 2 weeks after taking my last pill. Acne returned and stayed. I breastfed Annie longer, so I went on the mini-pill (progesterone only). It was ok, acne improved. But I was paranoid about getting pregnant because it isn't as effective as the combo pills.

Then after weaning Annie, my doctor suggested I try Alesse, which is a lower dose pill, the theory being that women should take the lowest dose that is still effective. So ok, I try it. I kid you not I had my effing period for 3.5 effing weeks a month, with one week off. I actually lived in this horrific way for 3 full months, to satisfy both myself and my doctor that it wasn't going to change after my body adjusted.

So then I went back on cyclen and am still on it. My doctor suggested Mirena, but at the time I was pretty fed up with her suggestions (period for over three weeks, people) and just went back to what I know. I'm still considering Mirena though, because even though we're decided on not having any more kids, a vasectomy seems just so permanent and I have a fear of changing my mind. I guess maybe that means I'm not 100% decided? 99.9% for sure.

I've always wondered if its ok to take the pill for so long. Gut feel says it isn't. But all the research says it is. I think that a vasectomy is in my husband's future but he probably has a few years before we either decide to make our decision permanent, or change our minds.

@Jac - that is HILARIOUS! You can't blame a guy for trying. But still.

Elle said...

I took the pill (orthotricyclen for awhile, others I can't remember now!) from age 26-34, when we wanted to get pregnant. Clear skin, which I loved! and no obvious effect on my libido. However, after my daughter's birth I went back on the pill for about a year and had zero libido-- which improved after I stopped using the pill. BTW it particularly improved after my thyroid was tested (exhausted, irritable, impatient, no libido-- even after DD was 2 or so, so not obviously related to sleep deprivation etc.) and found to be slightly low, and I started a low dose of thyroid med. Makes a notable difference all around! All of which is to say, I will not go back on the pill/anything hormonal at this point in my life. We've talked about a vasectomy but my husband is reluctant. Right now we're using condoms (Kimono is a good brand!) but have had 2 scares so it's not ideal, but I don't see a better choice...

Caryn Caldwell said...

Hope it's going well for you! As for when to stop, I have no idea. If you're using it for birth control, then maybe after menopause is well under way? Your doctor could tell you when it's safe to go off, I'm sure. Hope the hormones aren't messing with you too much.

hush said...

Thanks for all of the date points, and welcome @Elle! I'm now two days in to taking Nortrel (I started on Satruday, on the first day of my period with the hope that this will stave off any breakthrough bleeding). So far so good.

Granted it hasn't been long, but the only difference I've noticed is that I have been NESTING like mad! I stayed up two hours past my bedtime last night to reorganize the kids' playroom, put away Xmas decor, and sort through outgrown kid clothes and put them into labeled bags to give to some friends. If this is a side effect of the pill, I can live with it! ;)

NK said...

thanks for the link, I've been living under the same rock.
k, off to read the article.