Birth control - malabsorption

[Kimberly123]

Amanda and Melinda, thanks for sharing your experiences. I agree with comments made privately that we are allowed to have a full range of emotions about something as life changing as pregnancy. I had changing feelings about many things over the last few months - especially while dealing with the huge hormonal changes and also going off of effexor. Don't let people with their own agenda's bother you. You don't have to answer to anyone in that particular regard and by sharing your story, your experience, your thinking at the time and now looking back, it allows others to take in a variety of information and experience and give context to whatever other information they also gather.

I would also suggest that you do volunteer at planned parenthood Melinda. Sounds like they could really use a compassionate open minded and thoughtful person there. I can imagine how vulnerable those women must feel at such times of their life. Can you imagine the types of personalities they might be exposed to? I think volunteerism is a super idea in general. I do a lot of it myself.

Again, I really appreciate hearing the personal experiences that you shared. I do not ascribe to any particular faith and I do not see your posts as being for the purpose of pushing any particular religious agenda. I just see it as you sharing how you made your decisions and what happened along the way. It's funny how that can be used so insidiously to attempt to dismiss another person. I know that prior to recent changes in the community you may have felt you could openly write about what you felt and thought and did. It remains important to do that in order to give others the chance to make up their own mind from as many different experiences as we can offer. And you know what, they might say - well it didn't work for you so I'll never do that. Or they might say, well I am willing to take that level of risk etc. The point is, your input is very valuable as is.

[DS2000]

"Can you imagine the types of personalities they might be exposed to?" As if you know anything about my personality? All you know of me is some words on the internet. I find it amusing that your innuendos are ruder than anything else on this thread, but whatever floats your boat. I could not possibly care less about your opinion of my writing style. Perhaps you could consider dealing with the subject matter rather than focusing on me personally.

The person who started this thread was looking for hormonal birth control to prevent pregnancy. That is what she wants. Suggesting charting or barrier methods or NFP or whatever else....that's not what she's after. She wants to avoid pregnancy. And the best way to do that....is hormonal birth control. (Not to mention your ignorant suggestion that she chart while on the pill at the same time - which is impossible - and certainly illustrates your lack of understanding about how birth control works).

As for Planned Parenthood...your nasty innuendo about my personality aside...I have been a senior volunteer counselor for a long time, and I actually train other volunteers in addition to client counseling...you have no idea what it's like or how difficult it is. But this I know....I will never, ever allow anyone to advise on birth control and related issues without saying what I know to be true, based on a great deal of experience and training.

I am supportive on this board with great frequency, generous with my time and knowledge and experience with the DS, and have been helpful to many people. But when people start to give advice which could harm somebody else, as is the case on this thread, especially when it's a subject on which I am an expert, and something which I deal with all the time, I will speak up and I will do it assertively. You are free to put my posts on ignore if you don't want to read them.

And you're right - women who come to Planned Parenthood with unplanned pregnancies are extremely vulnerable - and the one thing they want to be sure of is that it NEVER HAPPENS AGAIN.

If you need to avoid hormonal birth control for some reason...for those of you who have already had children...the IUD is a great option for birth control. As far as barrier methods, if that's what you want....a cervical cap is your best bet.

And for those of you who are in your early 30s up to age 35 who want to get pregnant ever....there's not much time left. Fertility declines starting at age 30. At age 35, the decline becomes rapid.

[AmyLizTN]

Any input from someone who has taken oral hormonal birth control?

[DS2000]

I was on birth control pills for years. I never got pregnant using them. Also, obesity can often be a reason people have trouble getting pregnant.

Since I had my DS when I was 38, I was already not all that fertile so I wasn't concerned (and wasn't having much sex for the first 18 months post-op anyway). By the time I was pretty sexually active after the DS, I was already almost 40 (and on the pill) and my fertility was already on its way out at that age so not much to worry about in terms of accidental pregnancy.

But the problem is it is very individual and you might not absorb the pill enough to make it reliable. And you are young and probably very fertile. Just like the DS works differently for different people, some people may absorb the hormones in the pill better than others. Estrogen is fat soluble so you *could* malabsorb it enough to make it ineffective as birth control. That's why a hormonal method that is not ingested is more reliable for DSers - nuvaring, or the patch.

If you really don't want to get pregnant - don't take the risk of relying on birth control pills. Use another hormonal method.

Also - the only useful comparison would be with someone who was post-DS who is your age. Someone who is let's say 35 - her fertility is already diminished compared to yours. But again - we each have different levels of malabsorption so there's really no way to know how you would or would not absorb the pill. That's why it's not a reliable method for you.

[DS2000]

Also wanted to add that depo-provera (this is a shot you take every 3 months) is not a good idea for DSers. It is associated with bone loss and we are already at risk because of our calcium malabsorption issues.

[AmyLizTN]

Is there any way to test the degree to which I am absorbing? I have several months before the wedding, so there may be time to find out what's working for me. I'd love to take something that reduces the frequency of my period and relieves my cramps.

[DS2000]

Nuvaring and the patch deliver the same hormones as the pill does, just in a reliable way that doesn't involve ingestion. In theory you could go on the pill for a couple of cycles, and then get bloodwork done several times in the cycle to check your hormone levels, but the problem is that your malabsorption rate may not be or stay consistent and just because one month your levels might be okay, does not mean that would be true the next month.

Bottom line is this: oral contraception is not a reliable method for you. The most reliable contraception for you is hormonal contraception, delivered in another way other than ingestion.

Your options are Nuvaring or the patch.

If you don't like the idea of inserting something vaginally, then use the patch. It's very easy - you just put a patch on once a week for 3 weeks, and then no patch the fourth week (and this is when you will get your period). Your periods should get lighter, shorter and less crampy, just like most women experience on the pill. The frequency will be a period every 28 days like clockwork. It's the same for Nuvaring - a period every 28 days. Same for the pill - a period every 28 days. This is normal and healthy.

You may feel differently about using something vaginally after you've been sexually active for a while - and then you can always switch from the patch to nuvaring if you want to.

[DS2000]

More reasons not to use depo-provera:

Advantages

* Private.
* Effective after 24 hours.
* Does not require regular attention.
* Does not interrupt sex play.
* Has no estrogen.
* May decrease risk for ovarian and uterine cancers.
* Women can start Depo Provera 6 weeks after giving birth.

Disadvantages

* Causes loss of bone density and risk of osteoporosis.
* Does not protect against sexually transmitted infections, including HIV/AIDS.
* Requires injections every 3 months at a doctor's office.
* Delay of return to fertility.
* Irregular bleeding.
* Most women experience weight gain [study of link between Depo Provera and weight gain: Women using depot medroxyprogesterone acetate (DMPA), commonly known as the birth control shot, gained an average of 11 pounds and increased their body fat by 3.4 percent over three years, according to researchers at the University of Texas Medical Branch (UTMB).]

Future Fertility

Women who want to become pregnant may stop using Depo Provera at any time. For some women, fertility returns immediately. For others, it may take 6-18 months or longer for the body's hormone cycle to go back to normal.

Going Off Depo

The book Contraceptive Technology says: "It is not possible to discontinue Depo Provera immediately. Weight gain, depression, breast tenderness, allergic reactions, and menstrual irregularities may continue until Depo Provera is cleared from a woman's body, about 6 to 8 months after her last injection. After discontinuing Depo Provera, women may also have a 6 to 12 month delay in return of fertility."

[DS2000]

With the patch, you can just stick it on your butt once a week, alternating sides.

http://www.orthoevra.com/how-use-pat...re-to-put.html

[AmyLizTN]

the shots wouldn't rely on intenial absorption, would they?