My mind, my thoughts, my words

For the Ladies (and their curious partners)

Especially when you’re young, you have little knowledge of what is out there in terms of menstrual protection and contraception. I’m still in my early twenties but I’ve tried a bunch of things (I generally prefer more ‘natural’ things) and thought I’d write a brief summary for those who are confused or want to look at alternatives to what they’ve been doing so far.

Since you might not read to the very end, a quick note up-front: I created an anonymous survey for females to look at whether there might be any links between personal background and side-effects or tolerance to certain contraceptive methods. Just have a look – would be great to get many responses. Maybe there are women who have irregular periods are more likely to agree with the copper coil, for example?

Menstrual Protection

  • Disposable menstrual pads
    I don’t think much explaining is needed here.
  • Reusable menstrual pads
    I only recently came across these. They come in various fabrics, I just got some bamboo fleece and bamboo velour ones. They are much friendlier to the skin (natural fabrics, more breathable than the synthetic stuff you get in the supermarket), can be washed and reused for years which makes them economical and environmentally friendly. You can find them on amazon or through private sellers – I got mine off HonourYourFlow, very good value for a great product! These are perfect if your period is so light that tampons or cups seem unnecessary – which is the case for me after having gotten the merina coil. Plus, I’m going to cycle for a year or so and like to wear something natural and breathable that I can reuse so I don’t have to carry lots of synthetic pads with me and also in case I’m somewhere in the middle of nowhere where I wouldn’t get the chance to buy disposable ones.
  • Tampons
    Next to disposable pads very well-known and common so I’m gonna save my words here again.
  • Sponges
    They come in two forms: natural sea sponges and ‘artificial’ foam tampons (gynotex).
    I have used a natural sea sponge before, mainly during sex. If you cut a regular sea sponge in half it’s very unlikely that your partner will feel it (especially because they are really very soft) and they should still absorb your flow quite well (if you’re not bleeding too heavily) (but use a ‘full’ one for regular menstrual protection so you don’t have to wash it out too frequently). I never had problems getting mine out even if it was at the ‘far end’ (your vagina is only around 7 cm long when not ‘aroused’). Washing them can be a bit of a mission though, particularly if you inserted it quite deep or when penetration pushed it right up, because it’s not just blood but also mucus that gets on the sponge. You can use the sponge for several months.
  • Menstrual Cup
    I have been a cup-user for a few years now and I absolutely love and recommend menstrual cups! It’s basically a plastic cup that you insert into your vagina (worn lower than a tampon) to collect your flow, and if your period is light you can just leave it in place for around 8 hours before emptying it. If you don’t have water to clean it after emptying and before reinserting it you can simply ‘pee it clean’. I had my first mooncup for around 1 1/2 years before getting a new one as it didn’t suction that well any more. Saves you a great deal of money and is also environmentally friendly. Plus it doesn’t leak often so you can get away without a pad and it’s great for exercising and travelling. By all means, do not forget to take it out if you’re about to have sex or else your partner might get hurt!
  • Softcup
    I just ordered my first batch as I have heard good things about them. You can use one softcup for the length of one period. Similar to a regular menstrual cup you simply empty it every now and then and pop it back in. Unlike the regular cup you insert it completely into the vagina (it will slide into place under the cervix and behind the pubic bone). This and the fact that it’s soft (as opposed to the hard material of the cup) allows you to wear it during sex. It’s also more economical and environmentally friendly than regular pads and tampons. However, I’ve heard that due to it’s position it doesn’t work for every woman and it may leak during sex.

Here a wee comparison chart to give you an overview.

regular pads reusable pads tampons sponges cup softcup
environmentally friendly x x x x
cost effective (the more x-es the longer it will last) xxx xx xxx x
doesn’t inhibit physical activity x x x x
can be worn up to 12 hours x x
cannot be felt whilst wearing x x x x
can be worn during sex x (cut a small one in half – works for me) x (best when cut in half) x
can be worn overnight x x x x x x

Contraception

There’s not one thing that works for every single woman (hence you might have to try a bunch of different methods to find what works for you, but even that can change as your body ages and changes), and not all women like the same thing (some prefer hormonal, others non-hormonal contraception…). Fortunately we live in a century with an abundance of options…

Non-hormonal:

  • Male condom
    What is there to say that you don’t already know? Protects you against STDs and pregnancy. Can make sex less messy when you’re on your period. May ‘interrupt’ the flow of sex a bit and may make you feel less connected to your partner.
  • Female condom
    I have not yet used female condoms, would be curious to try though even if I imagine it being a bit… weird. It’s nice that you can put them in up to eight hours before sex, allowing for more spontaneity and less ‘interruption’ as it’s the case with the male condom.
  • Diaphragm
    A diaphragm has to be fitted for the right size and can be reused. It’s similar to the softcup in that it covers your cervix (and may thus make sex on your period less messy) but in order for it to protect you against pregnancy you have to use it with spermicide.  You can insert it several hours prior to sex and you have to leave it inside your vagina for at least 6 hours afterwards.
  • Cap
    Works exactly as the diaphragm. The only difference is that caps are smaller than diaphragms. They are used less frequently and are mainly used by women who can’t keep a diaphragm in place due to the shape of their vaginas.
  • IUD (intrauterine device, coil)
    Also referred to as copper coil. It is inserted into your uterus and can stay there for 5-12 years depending on which type you’re fitted with. One or two threads will hang into your vagina so you can check whether it’s still in place. Your partner may be able to feel these, it will probably not hurt him but it might be uncomfortable and you can get the thread(s) cut shorter. The copper creates a hostile environment in which sperm cannot survive. Even if there are no hormones involved, there can be certain side effects. The way the copper coil affects your body is still not well-known, and every women reacts differently. However, in most cases women experience heavier and longer periods with more PMS. I have two friends with the copper coil (and almost got it myself but decided to opt for the merina instead – see below). One is very happy with it and says her periods last around 3 days longer than before, are heavier and more painful, but she says it’s not that bad at all. My other friend just got it and her uterus doesn’t seem to like it very much. Hopefully she will get used to it but unfortunately this is something you can’t predict. Have a bit of trust and give it time (3-6 months or for some women even a year) but if it doesn’t get better this may not be the right method of contraception for you.
  • Natural family planning
    If you know your body well, this can work great for you! My mum used this method throughout her life, she never touched anything hormonal and it worked for her (it helps to have a regular period). In order to know when you’re fertile and thus shouldn’t have sex you need check your body temperature and cervical secretions. It is advised to learn natural family planning from a specialist teacher. If you do it properly, it can be up to 99% effective, but mistakes (as well as illness and stress which can affect fertility signals) can lower this percentage to 75. It may be a bit of a time-consuming method but you will get to know your body better.

Hormonal:

The problem with hormonal contraception in particular is that you will mainly find horror stories on the internet. Don’t be put off by these – it’s more common for people to seek advice when something’s wrong than to sign up to a forum just to comment that they’re fine! Every woman is different and unfortunately no-one has yet found a way to predict how each of us will react to different contraceptive methods.

  • Combined Pill (oestrogen + progestogen)
    Probably the most common form of hormonal contraception. Pro: You can control your period and your period is likely to get lighter. Cons: You have to remember to take it every day and it introduced artificial hormones which can mess around with your system and give you all kinds of side effects (mood swings, breast tenderness, headaches, water retention…). There are various pills with different amounts of hormones on the market and you might have to try a bunch of different pills to find the one that works for you (and you should allow your body to get used to each pill for at least 3 months before making a decision). Definitely start with low-dose pills though! I seem to respond ‘well’ to hormones and did not have any major side effects, at least I didn’t notice any (except for some spotting on mercilon (very low dose) but gedarel seemed to work just fine (low dose). However, I only took the pill over a year with a few breaks in-between and especially when going off it I got extremely emotional and winy.
  • Contraceptive patch (oestrogen + progestogen)
    Very much like the pill only that you don’t have to take it every day. It’s like a plaster that you have to change every week (three times a month, and then you have a plaster-free week in which you have your period). My sister used it for several years and I think she was happy with it. It will get a bit dirty though (esp around the edges where it’s sticky) and isn’t something I personally would go for.
  • Vaginal ring (oestrogen + progestogen)
    Hormonal-wise like the pill and the patch but very low dose and you insert it into your vagina and keep it there for a 3 weeks before having your ring-free period week. Note that the vaginal ring can increase your risk of venous thrombosis up to 6.5 times (and so can the combined pill; from anywhere between 3 to 14 times).
  • Progestogen-only pill (POP, mini pill)
    The mini pill contains progestogen only. It is associated with fewer side effects (spotty skin, breast tenderness – often only for the first months though) than the combined pill but doesn’t allow you to control your periods. At first you may have increased spotting and irregular periods but as your body gets used to it you are likely to bleed very infrequently and some women stop ovulating completely (period-free can be great but also mean that you may worry whether you’re pregnant).
  • Contraceptive injection (progestogen)
    The injection lasts for 8 to 12 weeks depending on what kind of injection you get (Noristerat or Depo-Provera). It only contains progestogen so it comes with similar consequences as the mini pill. There are more side effects associated with the injection though, for example weight gain, headaches, mood swings, breast tenderness, it can cause thinning of your bones, and it can take up to a year for your fertility to return to normal after the injection wears off. As opposed to the pill, implant, or coil it can also not be reversed at any time until it wears off.
  • Contraceptive implant (progestogen)
    The implant is a little tube inserted under the skin of your upper arm. It works like the mini pill as it just contains progestogen, thus side-effects are similar (see above). With the implant you’re protected against pregnancy for 3 years. I have read many bad stories on the internet but heard only good things from two friends who have the implant – again, it works for some, it doesn’t for others.
  • IUS (intrauterine system, mirena coil)  (progestogen)
    Yet again, similar to the mini pill and the implant, the merina coil contains progestogen – a much lower dose however than the mini pill and the implant. Like the IUD (copper coil) it sits in your uterus and two threads hanging into your vagina. It can protect you for around 5 years. After trying to decide whether to get the copper or merina coil I opted for the merina. I figured a lighter period and less/no PMS might be better if I’m on the bike for a year. One week after getting it fitted I spotted for about 3 weeks. I then continues to have very irregular bleedings for around 8 months, adding to that mood swings. Then, after a period, I stopped spotting altogether and started getting very sore nipples and sore breasts, we thought I was pregnant! I did get my period in the end and since then have been getting very regular periods and no spotting in-between. Still often quite emotional though….

Non-reversible

  • Vasectomy
  • Female sterilisation

Here two tables to give you a better overview

Male condoms Female condoms Diaphragm/Cap IUD Natural family planning
Protects against STDs x x
Can ixnterrupt the flow of sex x x x (you could use condoms on your fertile days)
Have to remember daily/each time you have sex x x x x
Don’t have to think about it for years x
Pills (combined/mini) Patch Vaginal ring Injection Implant IUS Vasectomy/sterilisation
Hormonal and thus greater chance of side-effects x x x x x x
Have to remember daily/each time you have sex x
Have to remember monthly or so x x x x
Don’t have to think about it for years x  x

A very useful website with more detailed information can be found here on the NHS

uterus

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