Feel I'm being coerced into contraception choice I don't want

[utopian99]

Hi,
Not really sure if this belongs in AIBU, but not sure where else. Used to post on MN a while ago, around birth of DS1 and have mainly lurked since then. Am 40 v soon, and have been getting huge stress from my doctor here, the last place we lived et a. for the last few years to switch away from the combined contraceptive pill.
It works for me, I don't really want to switch, but keep being told that it increases breast cancer risk and blood clot risk. We don't have a family history of illness related to either of these, BUT I don't want to ignore what is increasingly high stress from outside to change either.

I liked the injection a while ago, pre-children, but it definitely made me gain weight, which I don't want to go through again as am a stone heavier than I'd like to be even now. Have had friends use the implant who liked it, but also heard it can cause months of spotting/bleeds, which negates the point of contraception, if half the time you can't have sex anyway?!
The medical consultants I've spoken to are pushing the coil really hard, but I know a few people who've had horrible pain/issues with this, again to the point it's affected their sex life.
This leaves the mini-pill, which I went on between our two DS (22 month gap,) but think it caused some pretty severe mood swings - although this could just have easily been exhaustion/new baby/2 under 2 etc..

Basically, nothing apart from what I'm on seems like it doesn't have significant downsides. I'm not really sure what my AIBU is, apart from that I feel like I'm being punished for wanting to just be able to go on having sex with my husband!? Like the subtext to this is if I don't want sex to make children, I should be made to give up now I'm 40 and pointless to society in reproductive terms.

(DH is aware of the pressure I've been put under for the last few years and is also saying he could get tubes tied, which he's open to but then that's a significant operation for him as well, and again neither of us know much about the possible downsides there, although it's yet another option.)

Thank you to everyone for your patience if you've got through this rant, and happy for admins to move this if better in another forum of course!

If I were you, I'd have my husband get the vasectomy.

To one of your other points, the majority of women diagnosed with breast cancer have no family history of breast cancer. About 85%, in fact, per the Mayo Clinic.

Female sterilisation is a much more significant operation than a vasectomy and with much more chance of complications. Really, if you are going down the sterilisation route it is a minor op with a low risk of any long term effects. Ok, some men suffer from swelling and pain for a few days, but you will be in considerable pain for a few days as a given. There is also a small chance that a vasectomy could be revers3d if you change your minds- but it is a slim chance. Female sterilisation is not reversible 8n any circumstances.

you’ve been doing the hard lifting of contraception for years- and have side effects or risk of long term health issues to continue with being the person who has to take precautions. Don’t go through a major op for this - your dp wants sex too- time for him to step up and undergo a relatively minor procedure.

Get sterilised if you can. I had it done aged 29. I fell pregnant almost immediately with all four of my kids and I've not been pregnant in the five years since I've had it done so it's worked well for me. Only issue is heavier, more painful periods but worth it.

I did have the mirena but it needed to be removed under General anaesthetic as the threads went awol and several attempts to remove it failed. It was ok other than that

If you can trust yourself to always use them then i've used condoms for 20 years happily. I have got pregnant every time i wanted to (4 times) on the first month of trying so the condoms are definitely doing their job! I always use durex ones and don't tend to get the thinner ones and haven't had a split (yet!)

The main downside is yes, it doesn't feel quite as good but i have a clotting disorder so don't have the usual options.

I wish diaphragms were more relisable!

Iv had mirena fitted now I'm in 40s as part of hrt. It's been great and can use estrogen patches

My GP had "the talk" with me in my early 40s saying that the effects of the pill could go on for about 10 years after you stop taking it and slightly raised the risk of getting breast cancer which is raised anyway when you are over 50, so I moved to the mini-pill and am lucky that I get along with it as I understand about 40% who try it, don't. After a few years on the mini-pill I saw a different GP who kept trying to push me to have a coil fitted as it is easier than having to remember to take a tablet every day, although I've been managing this for many years. I said I'd think about it and went back to the waiting room where I overheard to young women discussing how they'd had to have their coils removed as they were causing them mood swings and erratic behaviour. I didn't have one fitted.

I think a possible answer is to try different things till you find what suits you, but a better answer would be for your DH to have a vasectomy as it is a much smaller procedure for men than the one for women is.

"two young women" not "to" - sorry

I think YAB a bit U, sorry. Nobody is trying to stop you having sex. The combined pill comes with risks and the doctors have to advise you accordingly and be sure you understand, otherwise they risk getting sued.

Female sterilisation is not generally offered on the NHS these days because it is more expensive, carries higher risks, is hard to reverse and has a higher failure rate than newer options like the implant and the mirena coil.

This OP.
I buy Yasmin or the generic equivalent over the counter every time I go to Europe (Spain, Italy, Portugal).
I would trust those health systems to be as good as the British Isles...and obviously less paternalistic towards women in this case.

Another one here who's DH had the snip and all was fine and dandy. Sounds like yours is up for it so let him take his turn. By your age, having been on the pill for years and had the DC, you've done enough. It's really not a big deal for most men.

DH got the snip. He had a few days of feeling a bit ginger and it will save me two decades of contraception. He recommended it - it seemed the logical option when we had completed our family.

I feel like I'm being punished for wanting to just be able to go on having sex with my husband!?

This is a little dramatic, nobody is punishing you. They are medical professionals trying to take care of your health. The coils are suppose to be great, but if your done having kids I’d encourage DH to have the snip, far easier than female sterilisation.

Do you get bad headaches or migraines? The pill has increased risks if you do. My GP encouraged me to consider other contraceptives because I'm 40 and have migraines. She was also worried it was contributing to my depression. Blood pressure and BMI are normal, I've never smoked. Coming if it didn't help, but I've very happy with my Mirena, don't have to remember to take my pill anymore. If it's working for you though I could see why you don't want to change.

No one has mentioned the vaginal ring (Nuvaring is the brand name). I've been using it for years, since it was first released to market and could not be happier.

Insertion & removal are as easy as a tampon, I run months together so never have a period. Very rarely get a tiny bit of breakthrough bleeding, but only for a day or so and a pantyliner is more than adequate.

I've lost over a stone while on it after giving birth, so it has no impact on weight gain/loss, at least for me.

I don't know why it's not used more tbh!

I'm 45 and still take the combined pill. I've had some pressure to change too. I'm very outdoorsy and the coc pill works for me as I can time my periods, something I couldn't do if I still had them on the mini pill. Fortunately, the last doctor I spoke to understood this and is happy to let me keep taking it until I'm 50.

I don't have children and don't want the coil and I still had random periods when I tried the implant for a while - it had to be taken out early.

My dp was in and out in 20 mins with his vasectomy. Bit uncomfortable for a couple of days afterwards.

Compare that to two pregnancies, two births, two post-partum recoveries. Never mind years of your hormones being screwed up, weight gain etc etc.

If you're done with kids it's a no-brainer.

No one is "punishing" you, your GP has to inform you of the risks of your chosen contraception. That's just standard procedure. It sounds as though you have been offered several different options, but you've ruled them all out for various reasons. That's your right, of course, but you can't then take it personally and decide the HCP's are conspiring to stop you having a sex life when the options aren't endless.

The reason you haven't been offered sterilisation is because its much more costly, invasive and has a longer recovery time than a vasectomy. My DH had a vasectomy on the Friday (local anaesthetic, in and out in under an hour) and was back at work Monday no problems.

YABU in framing this as the GP being difficult/society not caring - it's true that society gives almost zero shits about women's reproductive health, but that's not why the GP is advising you to come off the CCP. It's because of the well-documented risks associated with taking it as you get older.

You can choose to accept those risks if you like, but at some point they will be great enough for the GP to refuse to prescribe it to you.

I know loads of women who've had no issues at all with the implant, myself included. There are also lots of women who get on fine with mirena etc.

It's absolutely up to you whether you try anything else, though. As PPs have pointed out, a vasectomy is very straightforward, done under local anaesthetic, in and out in an hour - maybe your DH should just get it taken care of?

I would seriously revisit the vasectomy conversation with your DH if I were you. Yes it has some (small) risks and is some faff to get organised, but every option available to you has some combination of risk and faff. However - there’s often a long waiting list for NHS vasectomies, so you’ll have to do something in the meantime anyway.

Personally I went with FAM after getting increasingly pissed off with every other contraceptive method I’d tried, but I have very regular cycles and a pregnancy wouldn’t be a total disaster so this works well for me. Still have had GP trying to talk me into contraception I don’t want though, particularly the coil. “Lots of women love it!” - how lovely for them, it’s still a no for me.

No one’s trying to punish you and if you feel like that then maybe it’s your DHs turn to handle the contraception side of things. After all you’ve had to do all of that for many years it’s only fair. Alternatively you try some other options but agree with your DH that if nothing works well for you after x months he has to go For the vasectomy. All contraception has side effects, it’s about picking which side effects your able to cope with and happy with. You just consider all options and go with what’s most likely to work best for you. Condoms is another option you should consider that’s not mentioned in your OP.

Call me an old cynic, but I wonder whether it's all down to money.
The pill costs, but with a coil they can just shove it on and forget about you for the next 5 years.
Female sterilisation is an op, requiring surgeons, anaesthesia, theatre time etc etc, whereas vasectomy is a quick in and out procedure.
Stuck to your guns and insist on what suits YOU.

I had the same issue. My DH had the snip. Procedure took about 20 minutes, was home within a few hours and was sore for a day or two. It was absolutely fine. It was absolutely the correct decision for us and I would recommend your DH looking into it more.

Yes, I've had this from the GP - pressure to switch to Mirena coil.

If it ain't broke don't fix it, I say. I was prescribed the current form of contraceptive because it keeps endometriosis in check, which it has done for seven years really well - not a dicky bird- and that is a far bigger and more likely to occur risk to my health than an increased risk of blood clots or breast cancer. I don't want the coil because I got endometriosis only after I had the copper coil fitted and I just hate the idea now of something being in my body the whole time. Plus years ago I became depressed after switching to Microgynon and the Mirena has the same synthetic hormones. Plus if it does go wrong it's a pain in the arse to get it removed again.

These risks have usually been over exaggerated anyway, as they were for HRT.

Also if you really don't want to see your GP and don't have any health concerns you can get contraception from places like Superdrug pharmacy service online - £30 or so for six months' supply. I had a full health MOT last year and feel great on my current contraception, plus appointments are like gold dust anyway so I won't bother seeing my GP for a little while yet.

Order on the Internet or buy from pharmacy
Bypass GP
You will have to pay, but less hassle