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Original poster

Mid 40s contraception dilemma. Both still fertile. Impasse reached - frozen!

37 replies

Greenlandrover · 19/08/2015 14:43

We are both 46. I have two young children from previous LTR.
He has none.
We lost a baby last year, early miscarriage.

I'd never (knowingly) had a m/c before and it knocked me for six. I'm still not over it. Consequently the idea of another m/c is alarming to say the least. It happened whilst I was on patch contraceptive.

Admittedly I wasn't 100% with the patch at remembering to change it so that doubtless contributed to the pregnancy.

But my boyfriend said his previous LTR became pregnant whilst on the pill and he seems quite confident she wasn't neglectful taking it, so he's had two women pregnant on contraception which makes me further dubious - I really don't want to risk another m/c.

He's asked his doctor about vasectomy, and I've researched sterilisation as I'm very worried about having to take hormonal contraception again. I've looked at everything including all the ones that are left inside long term.

He says he will have a vasectomy if I don't want to use hormonal contraception, and as he's sure he doesn't want children, that sounds ideal. However, he has had a heart attack not too long ago, and is now stented and on permanent heart meds, so it seems unfair to put him through another medical procedure - however straightforward a snip is, I know - but we both seemed to have reached an impasse with who makes the contraception decision.

Does he snip (me clipping is out as it's too invasive, bigger risks, and still with the possibility of pregnancy, and an ectopic one at that), or do I go back on hormonal contraception? We are both saying to eachother the same thing, 'If you don't want to do it, I will'. We just can't make the decision!

I'm due a heart consultation next week as I have a slight issue (short PR wave, no biggie) and I'll ask my doctor's advice too, but it's ultimately that either myself or my boyfriend have to say, right, I'll do it!

I've now told him I'll go back onto hormonal contraception but the more I think about it the more it scares me. But I can't bring myself to say to him, AI know you've had Heath issues recently and you shouldn't have to go through anther procedure, but you have said you don't want children, and I definitely don't want to risk another m/c, so surely vasectomy is the right decision?

Then again, I had my pregnancies age 38 and 40 and then the m/c at 45, and a maternal family history of pregnancies in mid to late Forties on my Mum's side, so I'm always aware I may still be fairly fertile (as he is, clearly!) and no hormonal contraception is infallible..

Your views or advice would be so warmly received, thankyou. I'm at an impasse and can't move.

OP posts:
LittleWoofDoesntDog · 19/08/2015 14:47

I personally always say no to female sterilisation - it's such a big deal, its a big procedure and will affect your hormones. What about the copper coil? Not sure what else to suggest, just my perspective that female sterilisation is not a good option

pocketsaviour · 19/08/2015 14:47

Can you not just use a barrier method for 6-12 months until he is further out from his heart op?

Original poster
Greenlandrover · 19/08/2015 14:50

Heart op was about 9-10 months ago.

We've been using condoms and because they're so awful have been stupidly lax with their use and relying on withdrawal lately.

No, not interested in any long term insertion contraceptives, LittleWoof.

OP posts:
SugarOnTop · 19/08/2015 15:13

have you actually discussed the sterilization options and procedures with a professional OP? Things have changed a lot and female sterilization isn't the 'big deal' and 'big procedure' it used to be.

"It can be a fairly minor operation, with many women returning home the same day. Sterilisation is usually carried out using tubal occlusion"
quote from : www.nhs.uk/conditions/contraception-guide/pages/female-sterilisation.aspx

Vasectomies also carry risks -it is NOT a 'small deal' or 'small procedure' nor is it 'less'. chronic lifelong pain is one of side effects experienced by many men and management options are reversal or lifelong medication.

i think you both need to speak to a health professional who can give you all the facts, statistics and take into account both your personal/medical histories and help you decide which option is best for you.

SugarOnTop · 19/08/2015 15:14

less risky that was meant to read

forumdonkey · 19/08/2015 15:15

My exh had both a stent following a heart attack and a vasectomy and I have some experience of both so I can't see why a vasectomy is a problem if he has no problem with it. It is a very quick procedure and it is only that, a procedure. I think the bigger picture is a more important consideration tbh.

hellsbellsmelons · 19/08/2015 15:25

Would you consider an implant?
Mine is brilliant.
It doesn't agree with everyone but worth considering as it lasts 3 years.

UrethraFranklin1 · 19/08/2015 15:42

I agree that people have old fashioned ideas about female sterilisation that just aren't true any more. It's not really any more of a big deal than vasectomy is, which is not risk free either.

But if he is willing and wants to do it, what is the problem? Let him go ahead. I don't think the heart problems factor in really.

Summerlovinf · 19/08/2015 16:48

I agree with the last poster...if he says he's happy having the vasectomy why are you challenging that?

MuffMuffTweetAndDave · 19/08/2015 17:01

The major problem with female sterilisation is the increased ectopic risk, not a joke at your time of life OP. Is there no way the two of you could just get your shit together with the condoms for a bit until he's healthy enough for the snip, if that's what he wants to ultimately do? I do think if he wants a vasectomy you need to respect that tbh.

Twinklestein · 19/08/2015 17:04

My dad has had a serious heart condition for 15 years. He had open heart surgery when it was first discovered, and has subsequently had 2 hernia operations, which were completely fine. The had no impact on his heart health at all.

A vasectomy is not a major operation. I wouldn't be worried about that personally.

Twinklestein · 19/08/2015 17:28

It's not just ectopic pregnancy you need to worry about.

For some women who have the Essure method, supposedly one of the safest sterilisation options, they have found it has slipped out of place, they have had allergic reactions to the metal, or it has perforated the Fallopian tubes.

Erin Brokovitch has started an awareness campaign in the U.S.

pocketsaviour · 19/08/2015 18:36

If bog standard condoms aren't doing it, you could consider the cap or the female condom. Got to be safer than withdrawal OP Hmm

Or just toss a coin in the air, or play rock paper scissors. If either of you are happy to have the procedure then what does it matter?

category1 · 19/08/2015 18:53

My ex had the snip, it was about ten minutes all in, local anaesthetic - you can go in with him. Smells a bit like pork when they zap the tubes. Grin

If his doctors are happy for him to have it, it seems like the best option to me. Unlike female sterilisation which generally involves a general anaesthetic which is a bigger deal than a local by a mile.

Couldashouldawoulda · 19/08/2015 19:02

Get him to go for the snip and solve the problem permanently, especially as he's happy to do it. You've been through pregnancy and birth twice recently, so he's not the only one who's already had a lot to put up with healthwise! :-)

tunnockt3acake · 19/08/2015 23:20

just wondering are there any costs involved in male or female sterilisation ?

OutToGetYou · 19/08/2015 23:49

In your situation I don't see why you shouldn't each sort out your own side of things. He doesn't want kids - he has snip.

You don't want to get preg - you take care of your contraception, hormonal or otherwise.

Meanwhile, use condoms [as well as hormonal if you prefer].

I'm not sure that at mid-40's you'd get sterilised on the NHS (something I have been thinking about but not yet managed to address with my GP. FPC were worse than useless).

Limer · 19/08/2015 23:59

I'd recommend coil. It will last 5-8 years so may see you through to early menopause. I had Mirena coils for 20+ years and loved them, v light/no periods and no hormonal side-effects (that's just my experience though).

But do talk to your GP or FPC and see what they think.

MagicalMrsMistoffelees · 20/08/2015 02:13

My husband had a vasectomy a fortnight ok. Local health clinic on the NHS, done by our GP, 15 mins from being called in til leaving the room. He couldn't believe how straightforward and painless it was. Slightly dull ache for a few days. Such a relief to know we don't need to worry anymore!

If he's willing, then go for the snip option!

Smilingforth · 20/08/2015 06:19

All very personal but sterilisation just seems way too much for me

Cabrinha · 20/08/2015 07:53

You didn't get pregnant when using hormonal contraception - you said you weren't using it properly, therefore, you aren't using it.

Get the vasectomy! FGS whilst you're both faffing about this you're using WITHDRAWAL?!!!! That's a fast track to another unplanned pregnancy.

Smilingforth · 20/08/2015 08:01

I'd not focussed that you are using Withdrawal - that's utter madness!

Savagebeauty · 20/08/2015 08:07

Why don't you use contraception properly?
Not changing patch..lax with condons. Withdrawal method.
That would minimise the risk to start with

differentnameforthis · 20/08/2015 08:17

its a big procedure and will affect your hormones Tubal ligation doesn't affect your hormones. It isn't a big procedure either, mine was done via 3 keyholes. I went home the same day, albeit sore.

It's just clipping/tying your tubes your tubes.

It's been a godsend for me, op.

Oh & I know several people who fell pregnant on withdrawal op, so it seems madness that you are going down this route. He doesn't have to ejaculate to release sperm!

Smilingforth · 21/08/2015 07:53

Just to reiterate if you continue to use withdrawal the chances you will get pregnant are high!