Hormonal contraception, an “obvious” choice…

…is the opinion I’ve read today: if in a serious, exclusive relationship, long-term contraception is “the obvious, logical choice” and any couple that uses “archaic methods” is irresponsible; the tone of the statement did not sit well with me since it did not leave any room for other options and possibilities.

There are two things anyone talking about long-term contraception needs to keep in mind:
– all available reversible long-term contraception methods put 100% of the burden on the women
– all but one available methods include hormonal manipulation, the remaining one is “archaic” in it’s own right


Hormonal contraceptives are not without side-effects; yes, the amount of hormones in modern contraceptives is orders of magnitude lower than ones used when hormonal methods were invented, but they still do have an effect on the body and all reversible methods available apart from one are based on hormonal manipulation. Some of the possible complications are serious or life-threatening (thrombosis, for example) and prevent a number of women from using any form of hormonal contraception on medical grounds, other still have measurable effect on the quality of womens’ lives (weight gain, aches, skin conditions etc). And no, the new formulas and not necessarily safer than the older ones, what the newest research seems to indicate.

There is also the question about psychological impact, harder to measure scientifically but one a lot of (former) users of hormonal contraceptives report: mood swings, changes to sexual desire or personality changes, including depression; all in all not something that should be easily dismissed…

While not all women using hormonal contraceptive report any of the side effects, the issue remains: some do and possible complications are real hence I do not understand and definitely don’t agree with condemning the choice of refraining from these methods all together. It is a personal choice to weight all the risks, after all. I, for one, do not see the benefits justifying the risks, at least not for myself.

Copper coil

What’s left for a woman that does not cross of the possibility of willing to become a mother in the future out but desires a long-term contraceptive measure, albeit without the risks linked with hormonal manipulation? Only the copper coil, which has a battery of side effects of it’s own and which can be summed up with three points:

  • it shares all the side effects of hormonal coil (infections, risk of perforations, albeit low, risk of dislodging or the low albeit very severe danger of ectopic pregnancy)
  • one of theaspects of how it works is by keeping the uterus in state of constant inflammation
  • almost no health professional actually advises this one unless all the other option are unavailable

So there it is: a choice between hormonal methods and an archaic, side-effects-loaded one. I absolutely don’t understand why women who choose other options are so often condemned as backwards-thinking, especially since there are viable other options that used consciously can be a more suitable choice for many.

First of all, I don’t agree with the backlash against condoms as a contraceptive method for people in long term relationships: it works and it removes the burden, also health-related, from the woman. As for the lowered sensations or danger of slippage / breakage, choosing the proper condom size is crucial and no, it does not boil down to “XL or XXL”, but to so called “nominal width” of the condom: if it is too small, it will feel too tight and lower the sensation (and be more likely to break), if it is too wide, it will… also lower the sensation and be more likely to break plus be at risk of slipping. But somehow I can bet you most likely did not hear about nominal condom width before… So do try looking into it before you condemn a condom all together (learn the condom trick!).

As a side note, as a woman I love condoms. They take the burden off me, they make it all more hygienic and even applying them on can be part of the sex-game and by now I know that well chosen, they do not lower the pleasure for my partner. So stop nagging about the condoms… Maybe it is not for you, but there’s nothing inherently wrong with it as a method.

And the widely looked down upon calendar method? True, on the face value (and literally), simply depending on the day of prognosed cycle length is not enough because even women with usually regular cycles can have an irregularity here and there, but the truth is, if employing other methods together (basal temperature, discharge and cervical position observation) this can be made much more accurate. A lot of hassle and maybe less effective than hormonal methods, statistically speaking, but still nowhere near bad choice is someone wants to avoid the side effects and understands the risks!

Then we have the bigger issue: there is no widely (uh.. at all…) available long term reversible method of contraception for men: even though such methods have been devised, they are not popularised and all of us, both men and women, should be at least slightly enraged by this.

Why? Because among the male contraceptive methods devised are ones that are almost without side effects (since they are mechanical not hormonal), highly effective, cheap and easily reversible and every single sexually active heterosexual man and woman should advocate for the research on these be sped up..!