HEALTH, LIVING, SHARING, WELLNESS

July 14, 2018

Going Off Birth Control

Four Years Off Birth Control

I mentioned in a recent blog post that I’ve been off birth control for four years, and I got lots of questions about it. If there’s anything I’ve learned through the experience, it’s that sex education in this country is lacking (we already knew that) but it particularly fails at providing young women with the information and tools they need to accurately track, understand and feel control over their fertility. Most sex education programs spend more time explaining the different birth control options women have, than they do explaining how to predict ovulation or manage the pain and bloating that comes along with menstruation.

That said, we’re also dealing with a White House that is poised to roll back women’s access to affordable birth control and safe abortion. I don’t know about you, but most of the girls at my high school got their birth control from Planned Parenthood. For us, the nearest clinic was a 30-minute drive away, and girls would literally carpool down to pick up their supply. Access to birth control prevented a lot of us from becoming mothers earlier than we would have wanted, but we were also kind of cheated out of ever experiencing natural cycles. I was put on hormonal birth control at the age of 14 after experiencing a severe ovarian cyst (it’s often used to treat and prevent them). But then the doctor encouraged me to just stay on it. Why? I think a lot of us were made to feel like birth control pills, rings or implants were the only options if we didn’t want to end up on the next season of Teen Mom. And it doesn’t stop when we exit high school. I’ve heard over and over from friends about how they are pressured into birth control options immediately after giving birth. What? Like you just went on a 9-month hormonal roller coaster ride and you don’t even get a break after having a human literally exit your body? That seems insane.

It happens to those of us without kids, too. The first annual physical I had after going off the pill went something like this.

Doctor: “Are you having trouble conceiving?”

Me: “No.”

Doctor: “How long have you been trying?”

Me: “Umm…I’ve been trying to not get pregnant for like….15 years.”

Doctor: “You don’t have any birth control prescribed currently.” 

Me: “Yes, I quit taking the pill when my last prescription expired.”

Doctor: “Oh, I can prescribe that to you today.” 

Me: “No, I’m not planning to take birth control.”

Doctor: “Are you planning to start a family then?”

Me: “No.”

Doctor: *blank face* followed by awkward silence. “If you aren’t trying to get pregnant then I suggest that you consider your birth control options. Are you interested in long-term birth control like the IUD?”

Me: “No.”

Doctor: “Condoms break, you know.” 

Me: *long stare* 

Doctor: “If you decide you want to discuss birth control let me know.” 

I have never left a doctor’s office feeling quite so “Whudindafuq just happened” than I did that day. It’s not an uncommon experience and its one that I hope is changing. I put a lot more effort now into making sure my doctors are supportive of natural fertility tracking. They exist!

There’s nothing wrong with being on birth control if it is the best option for you. Some of us need to be on birth control for health reasons. Some of us could be putting our job, safety or life on the line if we had an unwanted pregnancy. Some of us have partners who aren’t supportive or cooperative enough to support our choices in pregnancy prevention. This post isn’t about vilifying birth control or shaming people for taking it. I took it for almost 15 years and I owe it a big high five for not getting me knocked up at the ripe old age of 20. What this post is about is sharing the basic facts about cycles and fertility, and empowering you to feel comfortable going off if its something you want to do. This information is valuable, but if women lose access to birth control options or safe abortion, knowing this will become even more important for all of us.

That said, the topic is vast. I’ve spent many days this week staring at a blank computer screen. I am so overwhelmed with where to start and there are people who are so much more knowledgeable about vaginas than I am. I mean, I feel like kind of an expert since I have one, but there are definitely people out there who talk about it much more eloquently than I do. There are also people out there who are going to be profoundly uncomfortable reading this post. To that I say: get in touch with where those feelings are coming from because at the end of the day it’s related to why so many of us are in our 30s and lack these basic skills in the first place. There’s no shame in discussing vaginas, fertility or menstruation. NO SHAME. But anyways, how about some Coin Cunt art? Because I think Suzanna Scott’s work is brilliant but also it seems like a nice icebreaker before I share some suggestions for continued reading and then dive into a Q+A sesh about my sex life and lady bits.

 

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I think that there can be information out there about birth control that is really fear mongery. I don’t think we serve fellow women well when we make each other feel like birth control is going to kill us or give us all cancer.That said, there are a lot of things about birth control and the way we consume it and educate on it that make me raise my eyebrows a bit.

The hormones we experience throughout a 28-day cycle help regulate many systems in our bodies and impact various aspects of our health. Everything from our mental health, endocrine health and adrenal health (which is like…basically every aspect of human functioning) is impacted by our natural fluctuation of hormones. It just seems like such a delicate system to mess with on a daily basis if we don’t have to. Going off birth control made me aware of what I had been doing to my body. After a couple months off the pill I found my weight much easier to maintain, felt much less mental fog, had an increased sex drive (hey-o!) and I experienced more emotions, which felt good and bad, but I finally felt like the cycle of my emotions on a monthly basis was predictable and something I could anticipate and learn to enjoy.

 

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A SUPER BRIEF BUT HELPFUL ARTICLE

A couple years ago a fellow Luther Grad (Go, Norse!), Hannah Anderson, wrote a great piece that I felt did a great job of summarizing some of the information I was learning from hours of reading books, listening to podcasts and browsing the internet. Her article isn’t an exhaustive resource of the information or opinions that are available, but I think it’s a good place to start if you’re curious about hormones or understanding your cycle. You can read her piece, “Birth Control in Your Body: How it Works and Why You Need to Know“, in its entirety via this link, but I’ve pulled out a couple of my favorite sections below.

Why Having a Natural Period is Good For You

A regular cycle acts as a “canary in a coal mine.” Meaning, it tells you and your doctor a lot about your health. Menstrual cycles are one of the first things to go haywire, alerting your body (and your doctor) that something needs to change. Whether it’s stress, diet, nutrition, or other hormones and body systems, a disrupted menstrual cycle is a sign that something else has gone awry. If this cycle is covered up with or completely squashed with artificial hormones, you lose the ability to catch imbalances early. Think about what age most girls go on the pill… 16? 17? So from mid-teens and beyond, these girls don’t know what their body’s baseline normal function is. They don’t know what an unmedicated body feels like, and their doctor has lost an important measurement of health.

On a hormonal birth control there is no real cycle (ebb and flow of hormones), and therefore no uterine lining is built up. Without a uterine lining to shed, there is no real menstruation. You might have a few days of bleeding, but that’s a result of the hormone withdrawal, and it doesn’t give you any of the benefits of a real period. That’s right, I said BENEFITS of your period. They’re real. 

The scientists at CEMCOR devote their lives to researching menstruation and ovulation and proving why a normal healthy cycle is essential. Visit them once a month if you need a reminder of why your period is great. Here are reasons to smile about getting a real, full-blown period:

It reduces bloating (thanks to a drop in progesterone… so day 2-3 of your cycle is when you can get away with eating the most pasta)

It’s a natural cleanser. Shedding the lining of your uterus is how your body gets rid of the bad bacteria, and excess minerals (this can even help prevent heart disease)

Your metabolism spikes during your period (pasta!).

It can slow the aging process by getting rid of free radicals (aka, the things that beat up your body from the inside out, like pollution, cigarette smoke, and toxins)

The natural hormone peaks and valleys give you benefits such as increased sex drive, energy for monster gym sessions, better decision making. 

My notes: This section from Hannah’s article helps me understand why I feel healthier being off the pill. It also makes me question birth control methods that allow you to have 4 periods a year. It just seems like menstruating, no matter how painful or inconvenient it can be for us, is really valuable to our overall health. Also worth noting that just because you’re using non-hormonal birth control doesn’t mean you are in the clear from experiencing negative side effects or impacts on your health. If you have the copper IUD I would also encourage you to research that and how/why it works. Hannah’s article has some information about it (in short: if I had to choose between being on the pill and having an IUD or Copper IUD I would choose the pill).

Knowing these 4-6 days = Freedom

I teach college anatomy and physiology part-time, so allow me to slide into professor land right now (for my awkward hand gestures and PowerPoints of my dog, you’ll have to actually take my class). First off, babies can’t happen unless a sperm meets an egg, right? We all have that part down? Solid. Moving on.

Day 1 of a female’s cycle is the day she starts her period. Typically, periods last from 3-5 days (so days 1-5 of your 28-day cycle). A woman typically ovulates around days 11-14. — This can vary, as some of you might be early or late ovulators. This is why knowing the signs of ovulation is a huge help. — When a woman ovulates, an egg is released and finds its way down the fallopian tubes where it may or may not find a friend (sperm). A healthy egg and sperm might decide they like each other enough to nestle into the lining of your uterus and grow into a full human. 

The crucial thing to know about ovulation: an egg only lives for 24 hours (MAX 48 hours), and sperm can only survive for 3 days (5, if you have the world’s strongest swimmers). SO, babies can generally only happen if you have unprotected sex 3 days before, or 1 day after you ovulate. 4 days total. Most women use this information only when they want to get pregnant, but it’s equally helpful when you don’t want to get pregnant. 

My notes: I love this section of Hannah’s piece because it helps us realize that if we have the time and energy to track our cycle enough to know when we are ovulating, there are really only a few days that we need to be concerned about. Why put artificial hormones into your body every day, rather than avoid unprotected sexual intercourse 4-6 days per month? For me, the answer was simple, but I know it isn’t for everyone.

A BOOK YOU SHOULD READ

I loved the book “Moody Bitches” by Julie Holland. The book has caught some criticism for being “anti-medication”, which I think can be a valid criticism, but I also think the author’s points are valid and valuable.

The book aims to educate us on what a natural cycle is like, and what natural ups and downs we will experience throughout a natural 28-day cycle. The author doesn’t question the fact that depression and anxiety are real conditions that need to be treated with medicine, or that you should have the option to medicate them if you choose to. The value that the book provided to me, was helping me realize that our natural cycle gives us days of depression and days of anxiety on a recurring, predictable schedule. When I wasn’t aware of what my cycle looked like, or when these days would occur, it was easy for me to feel like I was a moody, irrational bitch.

Like most women on a natural cycle, I have one day about 5 days before my period where all of my hormones plummet. It can leave me feeling more than just a bit depressed, it is 24-hours of feeling complete despair.  It doesn’t matter how productive the day before was or the great plans I have for the upcoming weekend. My hormones crash and it leaves me mentally wrecked. There’s little I can do to make myself feel better, but knowing that it is part of this cycle, and being able to anticipate and plan for it makes me feel really empowered. There’s also light at the end of the tunnel when you track it and know that 9 times out of 10 you are going to wake up the next morning feeling 100% back to normal.

When you are putting artificial hormones into your body on a daily basis, it is really hard to reliably predict or understand when this will happen or if its happening due to hormones or mental health concerns. Depending on what your natural hormone levels are like, and how much of each hormone is in your chosen birth control form, you really have no way of knowing what your mood will be on any given day, predicting it or controlling it. This can make a lot of women feel depressed or anxious on a daily basis, and sometimes we don’t connect this to the fact that we are toying with our natural hormones.

On the upside, your natural cycle will also include a week where you feel more confident and sexier than ever. Your partner will come to recognize this as the week where you won’t leave them alone. It’s your body’s way of encouraging you to find a mate and mate. But when you know this week is coming and can plan ahead, you can use that energy to go on a great vacation (one filled with self-confidence), pitch a big project to a potential client, or lead a workshop. And, you know, make sure you are planning on having protected sex and have the required supplies on hand.

Despite some of the criticisms of the book, I think it should be required reading for all women (and men….I made Josh listen to the audio-book during a long drive). Take her criticisms of medicating lightly, if you can, or avoid this book if that is a trigger for you.  I found tremendous value in what she says about women’s ups and downs, mood swings, sensitivities and anxieties and now I view them more like super powers that we get to experience, and that we can anticipate and control.

ANOTHER BOOK + AN APP YOU’RE GOING TO LOVE

Another resource that I have become absolutely obsessed with is Alissa Vitti, her writing, and her MyFLO App. Alissa is the author of WomanCode, which is an incredible read if you’re interested in women’s health, but her MyFLO app should receive some sort of Nobel Pussy Prize.

The app basically takes everything I have mentioned so far in this post and packs it into a little app. It helps you track your entire cycle, along with all the ups, downs and symptoms that come along with it. It will help determine when you ovulate, and it notifies you as you move into each of the four phases of your cycle (follicular phase, ovulation, luteal phase, menstruation) and it will tell you what emotions you’re likely to feel that week, what type of workouts might be the most beneficial (crossfit today? yoga? No workout at all?), what types of foods will benefit your body during that week (working certain foods into your meals can help you avoid some of those hormonal plummets) and what some of your strengths and weaknesses might be (did you know that some phases are more supportive of creativity, or productivity, or project management?).

One of the best parts of going off the pill has been the empowerment I feel in knowing my cycle so well, in learning how to support myself by using the food I eat or the activities I choose, and by recognizing that I have certain strengths and weaknesses each week and finding power and value in that rather than feeling like I’m irrational or moody.

The other thing about this app that is amazing, is that you can add your partner to it, so that they also receive an email when you move into each phase. It gives your partner the same information it gives you, letting them know what sorts of activities might be beneficial, or what types of things they could do to support your mood and emotions (stay out of the way, plan a relaxed movie night, get frisky). It might not be for everyone, but I love this feature.

Side-note: Alissa was interviewed in this episode of the Lively Show podcast (episode #85). It’s a great listen!

Q+A SESSION

I posted on Instagram Story and asked people what questions they have about birth control. Over the course of 3 days, I received almost 100 questions. This is the point where I remind you that you aren’t alone if you feel like you’re learning any of this information for the first time, or if you feel terrified by the idea of going sans birth control. Thankfully a lot of the questions were repeats, but here are my answers to most of them:

Why did you go on the pill?

I was put on it at the age of 14 by a doctor after experiencing an ovarian cyst and then was encouraged to stay on it to prevent future ones.

How did you go off the pill?

I just quit cold turkey. You can also opt to taper off it if you are worried about side effects. Consult your doctor.

Why did you go off the pill?

Once I learned more about my cycle and ovulation, it just felt ridiculous for me to be taking hormones every day when there were only a few days a month I needed to worry about. Once I started noticing how much better I felt off of it, I made the decision to stay off.

What type of birth control were you on?

I have always taken a hormonal birth control pill. I did try the ring once but didn’t like it.

Are you actively trying not to get pregnant?

Yep!

What method do you use instead of the pill? 

I use the MyFLO app (mentioned above) to track my cycle and predict ovulation. We rely on condoms to have safe sex during weeks 1 and 2 of my cycle.

A lot of people hear the word “condom” and are like “Ugh, no, never.” Let me say this: condoms have come a long way in the last 10 years. If, as a male, you think sex is less fun with condoms, I think that its at least partially some toxic masculinity talking. If, as a female, sex is uncomfortable with a condom: try different brands or use a lubricant along with it. In my experience a high-quality condom that comes pre-lubricated results in an A+ experience for both parties. Pro tip, if the idea of buying condoms still makes you giggle like a 17-year-old high school boy you can order them in bulk on Amazon. You’re welcome.

Here’s the thing about condoms, kids. If you aren’t in a committed relationship, you should be using them anyways, regardless of whether or not you’re on the pill, in order to avoid sexually transmitted diseases as well as pregnancy.

Do you want kids? 

I wrote a long post about our family plans here. In summary: we aren’t in a rush to have kids since we’re open to the idea of adoption if we do want a family. Meaning, if the clock runs out, that’s fine with us.

Would you get an abortion if you had an unexpected pregnancy?

We support a woman’s right to choose and women’s access to safe abortion. If we were to experience an unwanted pregnancy I don’t think abortion would be an option that we would choose for ourselves at this point.

Do you have anxiety about getting pregnant since you aren’t on birth control? 

To be honest, I had more anxiety and pregnancy scares when I was on birth control then I’ve had since going off. I think the hormones we put into our bodies using birth control can cause a lot of pregnancy-like symptoms (sore breasts, nausea, weight gain, etc., so many side effects of birth control are identical to pregnancy), and those freaked me out on a regular and recurring basis. Now that I know my cycle so intimately, I have weekly, if not daily, indicators that my cycle is on-track and my period is on-schedule.

What changes did you notice going off the pill?

So many! And all of them were good ones! I found it easier to lose weight and easier to maintain. I feel less mental fog and more mental clarity. I really love the natural ups and downs of my cycle, and tapping into the natural strengths and weaknesses that I feel during each weekly phase.

I think the most interesting thing about being off birth control for so long has been observing how my cycle changes in length. A 28-day cycle is the most common, and typically I have a 28-day cycle. However, if I am exercising a lot it will shorten to a 24-day cycle. After we moved internationally I had 3 cycles that were 18-days, then it went back to 24. I mean, how interesting is that? To me, it has been really remarkable seeing how my body directly responds to changes in my life. I’m still trying to figure out why my cycle shortened to 18 days after we moved. I think it might have partially been stress and being super busy — but also could have been the time change? I was now awake and active during the times where I had been asleep, and I think that does interesting things to the body. Just shows how delicate these systems are and I’m truly fascinated by it. (If anyone else has experienced anything interesting with their cycle after traveling or moving internationally I’d be really curious to hear from you!)

After about 2 years off the pill, I started to be able to not only predict ovulation but feel exactly when it occurs. It is a slightly painful pinching feeling that might last anywhere from 20 minutes to several hours.

On a somewhat related side-note: it seems like once I went off the pill our dog was more in-tune  with my cycle. Walter is clingy to me when I’m ovulating, and keeps his distance when I’m menstruating. Random but interesting? Some brief internet research seemed like it is because birth control also impacts our scent, and we don’t have the natural changes in scent that we have on a natural cycle, which a dog can easily pick up on. So from now on when people ask me what I use for birth control I’m just going to say “The Dog Method” and leave it at that.

The biggest downside of going off?

I have a love/hate relationship with my hormonal breakouts. I get 1 or 2 zits exactly one week before my period starts. On one hand, it’s a reliable indicator that my cycle is on track and usually one of the first signs that my period is on the way, on the other hand: zits. Who likes them. The good news is that I found these pimple patches on Amazon and they are literal miracle workers.

Did your period change when you quit the pill? 

It changed a bit. I spot lightly about one week before my period (another great indicator that things are working and my period is on schedule) and the fluid is a more vibrant red than it was when I was on the pill. I don’t think it’s heavier or more painful than it was previously. I’m uncomfortable and that’s typical.

Did you get pushback from your doctor?

See the example a the beginning of the post. Yes, I definitely had an awkward conversation. But, I don’t think this represents all doctors and I think this is changing.

What are your favorite feminine products?

Big fan of the period cup. Lee from America has a gigantic post all about how to use them. It’s a great resource. They are a very healthy option for you, but also better for the environment.

If you don’t want kids but don’t want to take birth control, would you consider having your tubes tied?

I would not consider having my tubes tied. There’s a lot of research now showing the hormonal impact this has on women and is something I would encourage everyone to research in-depth before considering. Vasectomies carry much less risk and I think if we were considering a permanent solution that would be the only one on the table.  There are valid reasons to have your tubes tied (some women could literally die if they got pregnant), but when you think about the fact that tube tying is commonly used as a form of birth control doesn’t it seem a bit ridiculous? It’s like “Listen if you don’t want more kids you need to cut these things off. Its the only option.” No, it’s not the only option and it’s ridiculous that we make women feel that way.

If you have additional questions that I didn’t answer, feel free to leave a comment below, message me via Instagram, or drop an email into the contact form. I’ll update this post if I find any new resources that I think are valuable!

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