Coming Off The Pill: What Are The Alternatives?

Not very good at taking a pill everyday for 21 days at a time? Check out these alternatives.

Are you and the pill over? You’re done with its crap – the weight gain, the hormonal spikes and the increased risk of breast cancer – and after a long-term relationship you’ve decided it’s time for you to seek out a change for your own good. Whatever. You’re over it. But what are you going to do now? Like a newly single lady, you need to assess your options and move on. You need to find out what is out there and see what you’ve been missing. 
Before you book your post-breakup doctors appointment, find out what your alternatives are with Marie Claire. We’re here for you, girl. 
The what? The Intrauterine contraception is the new buzzword for devices that are fitted into the womb. As well as copper coils (IUD or intrauterine device) there are now also two hormonal coils, made from soft, flexible plastic (called IUS or intrauterine system). You may have heard of the Mirena which has been around for 20 years (and, once inserted, offers protection for five years), but it’s just been joined by its younger, fitter cousin Jaydess, which is the smallest in the market and which lasts three years. Both add to their pregnancy protection by delivering low doses of progesterone, which thins the womb lining. This means periods get lighter and may, particularly with Mirena, completely disappear.

The insertion process can be uncomfortable, and there can be side effects such as pelvic or abdominal pain so prepare yourself by taking 200-400mg of ibuprofen one hour before the procedure, advises consultant gynaecologist Dr Ewa Hellberg from the London Medical private clinic. ‘Not only is it a painkiller, it also smoothes out the cervical canal, which can make insertion easier.’ 

Good for you if: you want to stop heavy periods or you suffer from PMS. ‘We don’t know exactly why PMS occurs,’ says Dr Guthrie, ‘but many women using Mirena say they no longer suffer from it.’ Say goodbye to crying in the pasta aisle of the supermarket while holding a family sized bar of Cadburys.

Natural Family Planning 

Log into any apps account and type in the words period tracking and you’ll be faced with an abundance of apps – such as Daysy, Wink and ONDO – that will help you keep an eye on whether you’re meant to be ‘on’ or not. These, as well as a high-tech thermometer that promises to calculate your chances of getting pregnant are becoming the new fangled ways to keep on top of your cycle and potentially prevent an unwanted pregnancy. Harking back to forms of Natural Family Planning (or the ‘rhythm method’) can help track your fertility. 
Good for you if: you’re up for keeping a daily record of your fertility signals (e.g. temperature, fluids coming from your cervix) and you have time to learn as it can take up to six menstrual cycles to be fully up to scratch with this method. 
The Patch 
This sticky patch attaches to your upper arm and delivers oestrogen and progesterone through the skin – each lasts for a week and can be worn in the shower. Then you replace it with a new one – easy. After you’ve used three, you have a seven-day break, during which you will have a period – although it’s okay to use up to six patches in succession if you want to delay your period. 
Good for you if: you’re not overweight. Of the six pregnancies that occurred during trials of the patch, four were in women weighing over 90kg (14 stone). It is also known for increasing bust size – something which can be viewed as a positive or negative. 
The Implant 
This matchstick-sized rod delivers progesterone into your system and offers protection against pregnancy for three years, which is perfect for those of us who can’t get into the daily routine of taking the pill. A newer model called Nexplanon has recently come on to the market, which is easier to implant in the right place in the arm. The biggest side effect can be erratic periods – but things normally settle back into a regular pattern in six months to a year.
Good for you if: you have IBS. ‘Many IBS sufferers find problems get worse cyclically,’ explains Dr Guthrie. ‘Because the implant stops your periods, this doesn’t happen.’ 
Those rubber things are still the only contraception that will protect you against STIs and while they might kill the mood, so does an unexpected pregnancy or a positive test for Chlamydia. Durex RealFeel uses a non-latex material called polyisoprene (also used by the brand Skyn) that feels more natural and is suitable for those with a latex allergy. For men who struggle to find a condom to fit (and feel like that’s a good excuse for not using one), point them to where they can shop from 95 custom-fit sizes for any length or width. 
Good for you if: you’re not in an STI-tested, monogamous relationship, or if you’re unlikely to remember to take a pill at the same time every day. 
Caya is the first new diaphragm to be launched in more than ten years and while it works in the same way – by physically blocking sperm’s access to the cervix – its new oval shape moulds to anyone, meaning it doesn’t have to be fitted by a doctor, so no need to get your feet into stirrups on a doctors table. It’s also lighter and easier to insert. You have to use it with spermicide – preferably one based on the effective nonoxynol-9 – and leave it in for six hours after sex, before washing for reuse. However, while Caya’s phase III trials were shown to be as effective as the traditional diaphragm, at the time of writing it hasn’t been indepdently evaluated by the Faculty of Sexyal and Reproductive Healthcare. While it’s not currently available from your GP, some Family Planning Clinics provide them and you can buy it privately online for around £30 (including from Amazon). 
Good for you if: you know when you are likely to have sex (forward planning is key), as it must be inserted prior to the act. 
The Injection 
Offering protection for eight to 13 weeks at a time (depending on type), the most common injection used in the UK is Depo-Provera. That’s been joined recently by Sayana Press, which is injected into the thigh or stomach. One benefit is that it slightly decreased the typical 2-3kg weight gain from other injections (possibly because it contains slightly less progesterone) and it’s also possible to administer yourself if you’re not deathly terrified of needles. Good for you if: you’re not planning to have a baby for the next year. ‘While most contraceptives reverse quickly when you stop taking them, the Depo-Provera injetion can mean it takes a year for ovulation to return to normal,’ says Dr Hellberg. ‘even after just one injection.’ The NuvaRing Worn in the vagina (and inserted by you), it delivers both oestrogen and progesterone. Wear it for three weeks, then replace with a new one. Keep this up until a period – not just spotting – naturally occurs, then take it out for four days before repeating this cycle. 
Good for you if: you get breakthrough bleeding on the pill; risks of this are lessened on this device.
Let us know what you use in the comments below.  

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