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Thursday, December 12, 2013

92

A Thing You Should Probably Read If You Use the NuvaRing

Vanity Fair published a long report on the NuvaRing in the latest issue, and they've put up an online summary that includes some horrifying figures and anecdotes about the female contraceptive, which has allegedly caused blood cots in "thousands" of users:

As NuvaRing’s manufacturer, Merck, which made $623 million in NuvaRing sales in 2012, is facing roughly 3,500 lawsuits against it, Brenner asks why, despite evidence of serious risk, this potentially lethal contraceptive remains on the market. Would a young woman use NuvaRing, Brenner asks, if she knew that the F.D.A. had determined that there was a 56 percent increased risk of blood clots when it was compared with birth-control pills using earlier forms of progestin? Karen Langhart, the mother of Erika Langhart, a 24-year-old who died of a pulmonary embolism on Thanksgiving Day 2011 after using NuvaRing for approximately four years, tells Brenner, “I want to warn every mother and every daughter: do not use the product that killed my child.”

And from a 2009 Mother Jones report on the same issue:

NuvaRing actually contains a lower hormone dose than most oral contraceptives, a fact its ads emphasize. But while birth control pills lose up to half their hormones in the digestive tract, the ring's dose is absorbed directly into the blood. Its package insert says there are no data on whether this route makes NuvaRing any riskier than taking pills. But that, say lawyers suing the company, is because Organon never studied the question before it marketed the ring. Nor did the FDA demand it—the agency based its approval largely on studies involving pills.

I've used the NuvaRing for close to five years. Anyone else out there second-guessing their commitment to this method?

[Vanity Fair, Mother Jones]

92 Comments / Post A Comment

adriana

No, but my friend is mildly freaking out about it. I told her just to talk to her doctor, but who knows if her doctor knows and more than we (or the FDA) do?

And now I'm wondering if the same dangers apply to the Mirena IUD, which also releases small amounts of hormones.

Sea Ermine

@adriana From what I understand the mirena has way way less hormones in it than the Nuva Ring. I think the big problem here with the ring is that no one ever bothered to test it and the FDA didn't care.

Briar Heart

@adriana The Mirena IUD only releases progesterone, and the Nuva Ring releases both estrogen and progesterone. It's the estrogen that raises the risk of blood clots. I know this because the Mirena and the progesterone-only birth control pill are the only hormonal contraceptives I'm allowed to take.. because I got a massive blood clot at the top of my left leg while on a combined estrogen-progesterone pill. Hope this helps.

adriana

Yes, very helpful, thanks! *hugs uterus*
(And I'm sorry you got a blood clot, yikes.)

Briar Heart

@adriana Thanks! Looking at my comment I realize I came across as a little over-dramatic (it was MASSIVE, you guys!!!!!11). *sheepish* The Mirena and the regular copper IUD are awesome, though. So convenient.

adriana

Not over-dramatic! It's scary stuff!
And yes, I <3 my IUD and try to preach its gospel but I know it's not for everyone.

This is my new username

@adriana At the very least her doctor can give her some information about what the signs of blood clots are, so in case there is a blood clot she knows what to look for.

I was briefly on a type of BC pill that had a much higher clot risk and my doc gave me instructions about what sorts of things should be a "get thee to the hospital NOW" sort of thing, which can make a huge difference. I think I would have been hesitant to ever go to the ER for leg pain if I would not have been warned about the risks.

apples and oranges

@adriana What are the "get to ER NOW" signs?

Briar Heart

@apples and oranges This is a good place to read about those signs: http://www.stoptheclot.org/learn_more/blood_clot_symptoms__dvt.htm

For me, I started out feeling like I had a pulled muscle near my hip. Then one leg turned purple and was noticeably bigger around than the other leg. It hurt to put weight on the leg or wiggle my toes. If you have any of these signs and you're on the pill, I'd recommend at least calling your doctor. If it does turn out to be a blood clot, the earlier they find it, the less likely it is to get to your lungs or cause other complications.

This is my new username

@adriana I can't really remember. Leg pain was the one that stuck with me, because that is the one that I could see myself kind of ignoring or assuming it would go away. I think the other ones were more obvious 'something is very wrong' like maybe chest pain or shortness of breath. My doc also focused on some prevention things like moving around as much as possible on long flights and car rides and stuff. Again, talking to ones doctor is probably best because I don't remember it all anymore. He was also talking to me about other possible side affects of the pill I was on, and one of the other ones had to do with bloody discharge from my nipples and I was like "AHHHHHHHHHHHHHHHHHHHHHH" and so my memory of other stuff was not...great...

adriana

"bloody discharge from my nipples"
Jesus Christ. That is the stuff of nightmares.

This is my new username

@adriana Yuuuuuuuuuuuuuuuuuup. You can see how that distracted me a bit from other stuff.

Marielle Echevarria Reading@facebook

@adriana Make sure you get your Mirena strings checked on a regular basis. The hormones are less of an issue than the fact that it can migrate inside you. Mine punctured my uterus and moved to my pelvis. I needed abdominal surgery to have it removed.

adorable-eggplant

This makes me just absolutely furious for that young woman and her family. Well, all those women and their families.

harebell

Whoa, this is really scary. I feel these are the types of risks that doctors rarely take into account in their eagerness to prescribe birth control to everybody.

my own story: I had to go off birth control pills because of the blood clot risk (for a genetic risk factor -- Factor V Leiden), and it was my own decision (later confirmed by other doctors) because my GP never asked about/mentioned this kind of risk to me -- I found out that there was an added blood clot risk from the pill from friends. She also said, "you've been on the pill for x years and it's been okay, so why don't you just stay on it?" Yet one of my parents died from a pulmonary embolism and he's the one I inherited the Factor V Leiden. Why would I do that?

I also do all kinds of other things that increase the risk of blood clots, like frequent long-distance flying. I'd much rather not risk dying than learn how to use other forms of birth control (or even go ahead and get pregnant -- as a 30-something that would actually not be much of a disappointment if it happened, though we are not trying). Such a bummer that there was no conversation about it -- and that even pretty enlightened doctors often feel they "know best" when it comes to the supposed necessity of hormonal birth control.

(For the record, if anybody wants an alternative, diaphragms + spermicide work perfectly well, and are way cheaper, too!)

juniper

@harebell That's spooky! According to my 23andme results, I have an increased risk (though not from F5, if I'm reading this thing correctly) for venous thromboembolism, and I've been on the NuvaRing for ages. Argh...

honey cowl

@harebell Wow, I can't believe your doc was like "it'll be fine!" I have a close friend with Factor V Leiden (homozygous, maybe you have hetero) and when her doc found out she was like STOP THE PILLS THIS VERY INSTANT! But she was diagnosed due to an enormous blood clot, so. Glad you're okay and I'm sorry about your parent!

she came in through the bathroom window

@harebell Yeah, I've never been on HBC, and I don't plan on it -- to me, it's simply not worth the risk and the side effects. My partner of nine years and I have always used plain old condoms, which for some reason blows people's minds. (We have had ONE break -- I went to get the morning after pill, everything was fine.) I have been curious about getting a diaphragm, though.

annejumps@twitter

@harebell I accidentally deleted, dang. Anyway I'm heterozygous for Factor V; I was already having different problems with Ortho Tri-Cyclen and didn't really mind going off it onto a lower-dose, differently made pill. I did see a specialist who felt that a decade of being on OTC with no signs of a clot meant I was fine, but it is of course still good to know about the disorder, and it brought it to my family's attention in case they had it....

len132

@juniper Just to let you know, 23 and me is actually in trouble for ducking regulation by the FDA. No one really knows what they're doing! They don't disclose their research, and they don't let anyone validate their methods! Be careful about what medical advice you take from them, because they are doing all the legal dodging they can to not be regulated. If you are worried about companies and regulation, worry about them.

angermonkey

@len132 BUMP! I saw this, too. As a biologist who does a lot of sequencing work I was super troubled by that letter the FDA sent. I mean, how hard is it to tell the FDA what sequences you're looking at and what database you're using to assess risk??? It makes me seriously wonder if ANY of what they're sending out is valid. My worst fear is that some lab tech is just running a microsat analysis and going "yup, there's a band, you're at risk for [insert thing here.]"

Which is not exactly what I'd consider "rigorous" and certainly not a valid assessment to base serious medical decisions on.

_____c_____

Remember, though, that a 56% increase doesn't actually mean that 56% of people using the Nuvaring will get a blood clot. It just means that compared to the other birth control there's 56% higher chance of developing a blood clot. If the original birth control came with a TINY chance (say 10/10,000 = 0.1% chance) a 50% higher chance in the Nuvaring would mean 15/10,000 people = 0.15% chance. It's important to actually look at what these increases in relative risk mean in the context of the real risk numbers.

Megasus

@_____c_____ It's not so much the numbers themselves that are scary, it's the fact that a) it was not properly tested by the FDA before being approved, and b) the fact that women are not told about this increased risk beforehand.

Argelfraster

@_____c_____ Thanks for pointing this out, I'm switching to the Nuvaring next week and I was freaking out.

BoatGirl

@Megasus Just to point out - the FDA does not actually do testing of drugs. The companies that are making the drugs are required to do testing based on all sorts of guidelines, then the FDA is supposed to review the results and either approve or tell them to go back and test more.
Sometimes, they'll approve a drug contingent on further testing or on monitoring it once it is marketed, because you may only be able to see certain things once a really large number of people have taken it.

Megasus

@_____c_____ Yes, that's what I meant, just didn't word it correctly. I am aware the FDA doesn't do the actual testing.

And then Katie said

Oh God, I had pulmonary embolisms while on the NuvaRing three years ago, and none of my doctors ever figured out why they occurred, but they all assured me it couldn't have possibly been the NuvaRing, and I just went back on NuvaRing last month, and excuse me, I think I need to go to the bathroom now and get this as far from my body as possible.

abigailnicole

@And then Katie said IUD! IUDs are progesterone-only, and the estrogen is where the blood clots come from. IUDs are gr-e-a-t <3

mistakeshavebeenmade

@abigailnicole: I really loved my IUD until I developed a progesterone sensitivity because of it. It was just chronic hives and having my eyes swollen shut for two weeks every month, which compared to blood-seeping nipples isn't that bad, but the hives still made me want to throw myself off a bridge. Sadly, I'll be on medication for this condition for the rest of my life, even though I broke up with my Mirena years ago. So I guess I'm saying that if you can, please love the non-hormonal IUD!

Megasus

I used to take both Yaz and Yasmin at one point, and totally switched when I heard about the higher risk with the new forms of progestin. My doctor said there was nothing to worry about, but I'd still rather be safe than sorry. (Especially since I have compromised pain sensitivity in one leg.)

orejitasmiamor

@Megasus I was on Yaz and then BeYaz for about 5 years and loved them. Never had high blood pressure or anything. I went off it when I was switching insurance and doctors and cities. My new doc wouldn't prescribe yaz so I was put on another pill that was "low androgenic activity," which just means it keeps you from breaking out, which I desperately need, and I got high blood pressure, crazy bacne, and depression. I guess we are all different! Now I have a mirena and I'm never going back to pills :)

Megasus

@Megasus Yeah, Yaz actually made my PMS worse. But I did find something that works for me after that, so yay! But I have literally been on all the birth control. It really can be hard to find something that works for your body.

TheMnemosyne

I had other terrible side effects from using the NuvaRing for three years. I went off of it for those reasons, but I'm glad I did.

beams!

This is the worst, I know the risk is still super small but I'm terrified of blood clots! I was on the last day of mine when this came out and I still debating whether to keep using it when the 7 days are up. I'm thinking I won't though. The fear of blood clots alone is too much. I'd rather fear getting pregnant. Maybe I'll get a lady comp. Life is hard.

sjöhäxa

@beams! I'm in exactly the same position! I called my doctor yesterday and she hadn't heard of this increased risk, but suggested that I stay on it for a couple months. I'm going abroad in less than a month, so now really isn't a good time to be playing around with different types of medication. I have one more day until I'm supposed to put it back in, and I don't know what to do :(.

beams!

@beams! i read that the actually odds of having a blood clot of any kind something on the ring is .00078% chance per year. This is according to a commenter on jezebel - super scientific i know. My friend suggested just doing some other things that counteract blood clots to lower the risk. Maybe a good solution?

honey cowl

@sjöhäxa get an IUD!!!

beams!

ps does any one know how long the risk is elevated for once you stop using it?? how long is my fear justified!

SBGBlogs

I'm kind of excited that I don't have to freak out since I literally JUST stopped using this. I didn't really have side effects, but my migraines started getting worse (which is the whole reason I can't take regular pills and had to switch to Nuva in the first place) so I figured it was time to go the IUD route.

Roxanne Rholes

So, a friend of mine does this kind of research for the FDA, and when I saw this I emailed him and said, basically, "what the hell are you people doing over there?" and his reply was, also basically, "this piece exemplifies that most medical writers have no idea what they’re talking about and neither do many of the researchers conducting the studies." Apparently the studies are incredibly biased and complicated - he said he gets contacted by a news source about articles like this at least once a month, and when he gives them balanced quotes, they never print them.

I will continue using condoms and tracking my cycle on a lunar calendar and drinking nettle tea. Because drugs are terrifying, and so is the industry around them.

Eyre Apparent

@Roxanne Rholes Amen, sister.

panther

@Roxanne Rholes What does the nettle tea do? I'm intrigued.

I'm Right on Top of that, Rose

@Roxanne Rholes I will continue to use lesbianism as my birth control.

Roxanne Rholes

@panther It's a hippy-dippy herbal tea that's supposed to "encourage menstruation" (and you know what they really mean.) I just drink it a few days before my period every month to be safe.

Roxanne Rholes

@I'm Right on Top of that, Rose HELLA JELLY.

panther

@Roxanne Rholes Good to know! I already drink it for the alleged skin clearing benefits, so that's an added plus.

OhMarie

I'm so torn about this kind of stuff--on the one hand, I think that the studies that go into pharmaceutical products are not often designed optimally (so the priorities tend to be 1) do the bare minimum to get FDA approval 2) add anything that you think might make a good marketing campaign and 3) don't risk anything that might actually hurt you), but the lawyers who target this type of thing are also SO predatory and overly scary. There's a really good diabetes drug that's almost never prescribed anymore because there were tons of lawyer commercials about a really tiny increased risk of bladder cancer, and it's a generic so it has no pharma company to argue for it.

Add to that the fact that doctors tend to do the analysis of side effects versus benefit in their own heads instead of talking them through with the patient and everything is a mess.

Eyre Apparent

I used this awful thing for about a month. It made my kidneys hurt so badly that I knew exactly where my kidneys were located in my back and also informed me that they desperately wanted out. I read the Mother Jones article then. I called my doctor and his nurse basically told me I was making it all up. I removed it and felt better within a day. I'm obviously still a little pissed off about it.

cabber

I used this several years ago and my biggest side effect was that I lost almost ALL sensation. I used to joke that that was made it so effective - there was no point in even having sex! I was disappointed because it made me feel more hormonally balanced than the millions of other pills I'd tried up to that point. Reading this new information scares me and makes me happy for my current method of birth control: Copper IUD all the way! I am not sure why my gynecologist never offered it to me as an option after seeing me year after year having issues with the pill. I was the one who had to bring it up to her after my friend raved about it. Going on year 3 and am very very pleased. So if anyone is worried about this new info. and can't tolerate a pill, talk with your doc!

AmandaElsewhere

So, this is real. I almost died this summer from blood clots which were a complication from taking birth control pills. I get that the big deal about NuvaRing is the FDA's non-regulation, but women need to be aware that putting hormones into their bodies does have an effect and does pose a risk. I'm happy to talk about my experience, though it was excruciating physically and to top it all off eventually led me to break up with my (now)ex boyfriend. 2014 anyone?

Briar Heart

@AmandaElsewhere I also got a blood clot while on birth control pills (Ortho-Trycyclin).

Did you get a pulmonary embolism or a DVT or both? I'm glad you survived the ordeal! It is a horrible experience.

AmandaElsewhere

@Briar Heart Yeah, DVT and PE. Granted, developed after a flight from Vegas to Philly (not really "long" flight but, I guess 4 hours is long?) but no genetic pre-existing condition or anything. Worst experience of my life, by far. The only thing I'm potentially thinking could be a positive, is that I look back and be thankful that it showed me how bad of a relationship I was in, and that I was able to get out before it went on. But right now everything sort of sucks.

Briar Heart

@AmandaElsewhere That sucks, big time! From one random internet stranger to another, hugs.

Mine was a DVT, I was lucky that it was discovered before it could get to my lungs. It went from my knee up into my hip on the left side. Like you, I also don't have any genetic predisposition to blood clots, and I didn't have any of the risk factors (I was 17 and a non-smoker).

I know you didn't ask for advice, so feel free to disregard, but mine happened almost 10 years ago and there are things I wished I had known then. First, never listen to a doctor who tells you it's okay to try an estrogen-containing birth control method even though you've had clots! I made this mistake a few years ago, and ended up with another (small) blood clot and a bunch of new varicose veins.

Second, I would recommend wearing your compression stockings religiously! (Even though they're fugly and uncomfortable.) My doctor never prescribed compression stockings for me after the clot, and I think that contributed to me getting varicose veins all over the place, some of which maybe could have been prevented if I'd been wearing compression socks all along. Right now I have varicose veins on both legs, my butt, my back, and my lower belly. :| I've had one surgery to strip veins but it didn't end up being very helpful in the long run, more veins just popped up in nearby places.

Obviously the number one priority is making sure you don't get another blood clot. Varicose veins aren't a life-threatening condition but they can be very painful and make you think that you might have a new clot.

Sorry to be such a Debby Downer in my comment. I wish you the best of luck in your recovery! Also, good for you for getting out of a bad relationship, even if it was through an awful circumstance.

AmandaElsewhere

@Briar Heart Funny, my doctor told me to stay away from compression socks. Also she told me to stay away from flights but IT JUST SO HAPPENS travel is my passion so I kinda sorta just booked a flight to Spain? And to Charleston?

Briar Heart

@AmandaElsewhere Weird, I wonder if it's different depending on the type of clot/where it's located/the lingering effects afterward? I was told that wearing the compression socks could prevent more DVTs and keep my varicose veins from getting worse, because it's supposed to keep blood from pooling down by your feet. Maybe my doctors are compression sock peddlers and their information is out of date. :P

Also, avoiding all flights would be so crappy! You can explain to the flight attendants that you're at risk for blood clots and you need to get up and walk around at regular intervals. I did this the last time I flew. They were super nice about it! They basically said as long as I wasn't wandering around when the "fasten your seatbelt" light is on, or during takeoff/landing, it was all good.

harebell

@AmandaElsewhere

huh, maybe ask your doctor why compression socks are not good for you? they are pretty standard for people with DVT-risk, unless maybe there is something special about your case?

anyway, I just wanted to say that while some people do find them uncomfortable, for me they are amazingly comfortable and give me a sense of more energy (I guess because the blood circulates more)! The only annoying thing is putting them on in the first place -- but once they're on, my legs never get tired and I have energy all day! really worth trying for yourself (if medically permitted)!

ponymalta

I do contraception counseling in a sexual health clinic, and we advise all of our clients who take hormonal contraception of the elevated risk of blood clots, as well as the signs of a blood clot. All medication involves risks. And there are so many women who take hormonal contraception that unfortunately some will experience side effects.

One thing that stands out to me is this: your risk of an adverse event (eg, stroke) is highest in the first three months of a new medication. So there were very possibly other factors if after four years this poor woman had a deadly blood clot.

The other thing is that while hormonal contraception raises the risk of stroke, and some forms more than others, they are still raise the risk much, much less than a pregnancy or giving birth do. Women should be informed about all these risks when making their decisions about contraception. No one should be pressured to take a form of hormonal contraception without knowing the risks, or the alternatives.

mynamehere

I wanted to jump in real quick as a doctor (not a particular expert in this issue, but it is an area of interest) and say that 1) I totally agree with the above posters that the way the FDA and drug companies go about conducting research is totally convoluted/non-transparent/often motivated by perverse incentives and 2) that if you personally have an increased risk of blood clots (smoker, known hereditary risk, obesity, older age) or if you have had side effects from a method than absolutely consider switching to non-hormonal methods, but 3) (and I think most importantly) the risk of blood clot, and health risk in general, of hormonal contraception in healthy women is minuscule, and the risks associated with pregnancy (including a MUCH higher risk of blood clots than any of the contraception methods) are very real and can be serious (worth it if you want a baby, but very real nonetheless). So yes, if your doctor doesn't have any discussion with you about what your contraception options are and the risks involved, that is unfortunate and you should bring it up. But also, contraception is awesome, and the risks are almost universally pretty low. And the Mirena is extra super low risk when it comes to hormonal side effects, so please don't abandon it because of articles like this.

ponymalta

@mynamehere <3 my Mirena

All lions are fierce

@mynamehere Thank you! I chose nuva ring because I was afraid to jump when it comes to inserting expensive and potentially side-effect-causing IUDs, but my annual exam is in a month and all forms of bc are free for me (university health care=great for not getting pregnant, terrible for everything else), so I think I'll finally go for the Mirena.

Gleemonex

@mynamehere My Mirena is the greatest thing in the history of ever. I am a tireless (and probably tiresome) Mirenavengelist to anyone who even kinda sorta sidewise mentions birth control at all. Yay Mirena!

discombobulated

@mynamehere I have an appointment to hopefully get a Mirena next week. So excited!

Marielle Echevarria Reading@facebook

@discombobulated Just make sure you are good about getting your strings checked. Mine punctured my uterus and migrated to my pelvis (just shy of my intestinal tract). Had to undergo major abdominal surgery to have it removed.

muralgirl

Aha! That part about the "lower dose of hormones" makes so much sense to me. The doctor told me it should NOT cause the crippling depression side effects that the pills caused, because the dose was lower. But it was just as bad, if not worse. I have a Mirena now, and it has been fine. Much, much lower dose maybe? (Eta: Oh yes, I see the commenter above has said that.)

yellowthings

The NuvaRing made me break out in vaginal hives! Little itchy bumps inside my vag. It was pretty awesome. They went away almost immediately after I removed the NuvaRing though.

Merin

I gained 30 lbs and almost completely lost my sex drive during the 2.5 years I was on the Nuva Ring. I shit you not, I went off it (and hormonal birth control altogether) and over the course of the following year my body just gradually shed the weight and my sex drive went back to normal. Same diet, same level of exercise and 30 lbs gone. I have been on about 2-3 hormonal BC pills before this and none had this kind of effect on my body.

meowmischen

@Merin Huh, I've been blaming breaking up with terrible-diet boyfriend and walking to work for my weight loss, (and one of the above for return of sex drive) but those both perfectly coincide with stopping NuvaRing. Iiiiinteresting.

missupright

@Merin Holy shit, this is the first time I've ever thought that maybe the reason for my unprecedented weight gain in the last three months might be the combination of new pill/anti-depressants, both of which have side-effects of weight gain. Just never connected the dots before. Shit. That makes me feel...less bad about being lazy?

Nutellaface

I'm kind of terrified now. There has to be a lady doctor Hairpin reader. WHERE ARE YOU HELP US.

sjöhäxa

I'm on the NuvaRing and am willing/ready to try something new, but I'm about to leave for a foreign country and don't want to be messing around with a new medication while I'm there. This really, really frightens me. Gahhhhhh.

abigailnicole

@sjöhäxa IUD! Talk to your doctor about it. Can last 5-6 years, requires absolutely zero effort from you, and progesterone-only, so not the very high risk of clots that comes with estrogen-based BC.

steponitvelma

I have been off birth control for about 2 years now, but before that I used the nuvaring for years with no complications. I actually have one in my fridge right now because I've been contemplating going back on it, but it looks like I'll be calling my doctor first.

klemay

Yiiiiiikes.

I've been using the Nuvaring for 2.5 years because of miserable/irregular periods, and the Pill didn't work for me (I'm horrible at taking a pill at the same time every day). After reading everyone's comments, I'm considering ditching hormonal birth control entirely, using condoms for birth control, and just putting up with miserable/unpredictable periods.

adriana

@klemay Try using a Paragard IUD, maybe?

abigailnicole

@adriana ditto. IUDs are magic. The #1 form of birth control in the world, except the US.

klemay

@adriana @abigailnicole I hear just as many scary things about IUDs as I do about other BC methods! I think I want to move away from hormones entirely, and the copper IUDs scare me. :(

adriana

@klemay
I'm no doctor, so of course take this with a grain of salt.
I think Americans really got scared off IUDs because of the Dalkon Shield scandal in the 70s, but the devices are different now. I'm assuming the scary things you heard about are "perforation," infection, and ectopic pregnancies. Definitely all possible, but all pretty rare.

As others have said on this thread, all BC comes with potential dangers. But with the Paragard, hormonal risk is moot, pelvic infection and perforation are risks mostly only at insertion (someone correct me if I'm wrong), and ectopic pregnancy is a risk only if you're having sex (obvs)—and to mitigate that risk you could use condoms, too.

(A note on periods: in general I believe the Mirena makes your periods lighter and the Paragard makes them heavier. My Mirena periods have been unpredictable but also almost nonexistent.)

PLUS I love that I don't have to even THINK about birth control for 5-7 years. It's just there, doin' its thing. To me, there's just more pros than cons with the IUD! :D

Cliterary Device

Hormonal BC scares the pants off me. I used two non-pill forms of hormones for two years and they both messed with me in ways that hampered my daily living. It's been over 8 years since I've been using FAM with condoms successfully... I don't think I'll be touching hormones again.

peacheater

@Cliterary Device Same here! And I don't feel like the alternative to using hormonal birth control is unwanted pregnancies. I've been successfully using just condoms for three years now, my mom used them all through her marriage until menopause (except when she had me, of course) and the nurse practitioner I spoke to about birth control options said she had had no problems with them in seven years either. I understand that statistically they do represent a higher risk of pregnancy than hormonal birth control, but speaking as someone with a fair bit of biochemistry background, I don't believe that there has been enough testing done for me to ingest (or absorb) these hormones.

she came in through the bathroom window

@peacheater Yay condoms! As I said in a thread above, my partner and I have been using only condoms for close to nine years now, and have only had one break in all this time. Sometimes I get jealous of the easy periods people on HBC seem to have, but for me it's just not worth it. (Also, I realllly don't trust myself to remember to take a pill, and although everyone seems to love their IUDs, the idea of popping that thing inside sounds excruciating. Plus, this puts the responsibilty of birth control on my partner instead of on me. Why the hell should I have to alter MY hormones?)

OhMarie

@she came in through the bathroom window Yeah, we've had two break and are coming up on 12 years. I am terrified of the insertion pain of IUDs.

I was about to say nobody ever died from condoms but I'm sure someone's tried to eat one and choked to death or something.

Anchovy Cake

I am from the same small town and was one year behind the girl that died in 2011 from it. While it is extremely unlikely to have life-threatening complications, it really shook that community and I know that most of the girl's from my HS stopped using their NuvaRings. FWIW, the risk is with all types of horomones, but it was painful to see a side affect of a drug affect my home so much.

snowmentality

I really would like more information before freaking out. What were the actual fractions of women who had blood clots on the Nuvaring vs. on other pills? 56% sounds like a huge increase, but are we talking about, like, 1 vs 1.56 in 10,000 women, or in 10 women, or what? And is the risk with Nuvaring significantly different than the risk with other hormonal birth control?

I have to be on hormonal BC because if I don't suppress ovulation, I get huge ovarian cysts. (Seriously, I was off the pill for less than two months last summer, and landed in the hospital with a cyst big enough to make my ovary twist around and cut off its own blood supply. It was not fun.) I've already accepted the slight increase in blood clot risk that happens with any birth control pill, because when compared to the near-certainty of giant ovarian cysts without it, I know which I pick. So I wonder -- is the Nuvaring really more dangerous than the other pills?

Honestly, the Vanity Fair article also pings my "selling fear" senses a little bit, so I'm inclined to be a little skeptical. I know manufacturers aren't always honest, but neither are lawyers, you know? I'd like more of a look at what actual science there is.

beatrixkiddo1

I read about this blot clot issue about a year and a half ago, and freaked out. I literally got up from my desk at work and pulled the thing out. Annnnd... Now I have a five month old baby. True story.

Zuckererbse

Hi, just joining the conversation to note that all forms of contraceptions come with some risk. I liked my Mirena IUD a lot until I had an ectopic pregnancy.

len132

The FDA and pharmaceutical companies definitely can be very flawed, but the stuff I see in the media about science is just beyond belief. Full disclosure, I did not read this article, but I would have to see the original data to really make a decision.

I've been on the other side of the equation, the one working to do the studies and get things approved. And let me tell you, the process is massive and insane. The amount of work you have to do and data you must produce to get approved is truly enormous. Sometimes things slip through, and that's terrible, but it's just not true that the FDA is just skipping along ignoring the regulations they are supposed to enforce.

orejitasmiamor

@len132 I've been really appalled at the coverage of this and also the Plan B thing that came out recently. I do reproductive health related research, too. The way the news is reporting this you would think that everyone on it is having strokes all over the place. I get so fed up about people assuming that one anecdotal story is solid evidence that something is dangerous. Give me a randomized controlled trial and a couple of population studies and I'm happy. Then again, this is just another one in a series of horrible screw ups related to contraceptives. .

kitnen

When I tried the Nuvaring, I ended up in the ER. I had chest pains and migraines so bad that I kept fainting. It was hell.

But I have been using the calendar method for most of my adult life, with no surprise pregnancies. You just never hear about the calendar method because it's FREE.

The website http://www.cyclespage.com uses data that I enter to predict which days I'll be ovulating. It sends me an email right before I ovulate, and right before I'm going to get my period. I can even look at my personal calendar when I plan trips, so I know when I'll probably feel too crampy/bloated to get into a bathing suit! :) It's super convenient.

TenyaLuna

From Hatcher (Contraceptive Technology) risks in perspective:
Mortality risk per year while
skydiving: 1 in 1000
automobile accident: 1 in 2,900
struck by lightening: 1 in 2,000,000
non-smoker age 16-34 using a combined oral contraceptive: 1 in 1,667,000
smoker age 35-44: 5,200

undergoing tubal ligation: 1 in 66,700
experiencing pregnancy: 1 in 6,900
legal surgical abortion at <8 weeks: 1 in 142,900

So, relatively, safe. Even if you're saying the risk should really be 1.5 or 2 per 1,677,000 (for Nuvaring vs combined pills). Tylenol and ibuprofen can also be deadly for some, even in patients without known risk factors but especially with certain risk factors (which you may or may not known about before taking, such as a hereditary liver condition). And I'd be certain that if I posted on the internet about the studies on tylenol I'd see dozens of comments about how it nearly killed them or someone they know. And certainly, while blood clots CAN be deadly, they are also not necessarily deadly either.

And not to disparage people wanting to go non-hormonal, by all
means, go for it. A large portion of the reason condoms and diaphragms fail is because while couples report using them, they're used "mostly" - sometimes they sit in a drawer or on a store shelf un-bought and then surprise, pregnancy. I used condoms exclusively for two years prior to getting insurance and have no problem with them.

But I love my Implanon, which will be changed to a Nexplanon next year, and I'll use until menopause unless there is some more definite reason I need to change.

To address points above:
The Paraguard is not used very often because of heavier periods and difficult insertion (Mirena and Skyla have fancy, easy to use applicators, Paraguard has a stupid one - thus can be a case of "well I don't prefer them ... how about a Mirena instead?") - when women come in wanting to discuss birth control and I tell them one uses no estrogen, 80% of women have no periods after six months, and it lasts for 5 years vs one that is completely hormone free, will very likely give them heavier periods but lasts for ten? They want the one with little to no periods, usually.

ciphressinchief

OK, sure, pretty small risk. But the risk of blood clot increases sharply if you're a smoker. Many of my friends are "social smokers" and would never tell this to their doc. And risk goes up if you are on a long plane flight. Is it really worth it? Especially as pills/the ring are 20x less effective that an implant/IUD: http://www.cnn.com/2012/05/23/health/iuds-implants-versus-pill-birth-control/

#IUDsforever

ciphressinchief

@ciphressinchief Oh and PS I have a Paragard and while my periods were godawful for the first few cycles, they are totally fine now. Don't listen to the horror stories.

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