Last week, a new study published in the Journal of the American Medical Association (JAMA) found an alarming correlation between hormonal birth control and depression. While doctors have known for a while now that birth control can cause mood swings and perhaps even depression, the new study puts the problem into a whole new perspective. Scientists found that after six months of taking oral contraceptives, women were 40% more likely than non-pill users to suffer from depression.
Now, correlation doesn’t always mean causation in science … but 40% is a really high figure. The study followed 1 million women between the ages of 15 and 34 over the course of 13 years.
Depression isn’t the only bad side effect of birth control pills. I recently wrote over at Care2 about how hormonal contraception can cause nutrient deficiencies. Hormonal pills can also cause weight gain, a lack of libido, and an overall feeling of numbness, due to the suppression of the natural female reproductive cycle.
Dr. Oejvind Lidegaard, a clinical professor of obstetrics and gynecology at the University of Copenhagen and a senior researcher involved in the study, told The New York Times that 40% “is not trivial.”
“… it is important that we tell women that there is this possibility. And there are effective nonhormonal methods of birth control.”
The question is: What are those methods, exactly? What non-hormonal methods of birth control are reliable enough for sexually active women to use with confidence? When we’re talking TRULY non-hormonal methods that have success rates over 90 percent, there are really only three options out there: the copper IUD, condoms, and the Fertility Awareness Method.
Option 1: The Copper IUD
I don’t want to rain on anyone’s parade, but here are the facts: Women often turn to hormonal IUDs like Mirena because they have lower levels of hormones than a contraceptive pill … but unfortunately, this recent study actually found that Mirena users had the HIGHEST rates of depression among hormonal method users.
Although IUDs are extremely reliable, only the copper IUD (which currently retails in the US under the brand name Paraguard) is non-hormonal. The copper in this device changes the consistency of vaginal fluids, rendering the environment inhospitable to sperm. It does all of this without any hormones, and therefore does not suppress ovulation, cause any kinds of nutrient deficiencies, or impact mood in any known way. Paraguard is more than 99% effective, making it one of the most reliable contraceptives on the market.
The only downside is that it does cause you to have pretty heavy periods, particularly at first, and may cause quite a bit of cramping. There have also been reports of the copper in the IUD causing an high copper levels in the body, which can lead to other problems. Nonetheless, for women who want to be completely hormone-free with their birth control method, it is the most effective option.
Option 2: Condoms
Good ol’ condoms are a standby for a reason. With perfect use, they’re quite reliable (98%), but you have to use them PERFECTLY (wear them every time there’s any kind of penetration, without fail) in order to see this success rate.
There are almost no health downsides to using condoms, unless you have a latex allergy – and even then, there are latex-free options. The big drawback is, of course, that they aren’t a ton of fun to use, and are often a burden for long-term couples who don’t need them for STD prevention.
Option 3: Fertility Awareness Method (FAM)
Before you laugh at me for this, hear me out: the Fertility Awareness Method (FAM) is NOT the Rhythm Method, and according to The Association of Reproductive Health Professionals, it’s actually pretty effective when done right: It’s between 95 and 99% effective, in fact.
The problem is that this high success rate is only seen when FAM is done PERFECTLY – and that’s pretty hard to do. Hence the unplanned pregnancies that you may associate with this method.
In order to do FAM right, you have to be very committed to learning about and understanding your body. You need to have great discipline, and be ready to spend time every day tracking your cycle.
This doesn’t mean looking at an app that says you’re on “day 14” and then abstaining from sex that day. Rather than relying on numbered days of the month, you need to test internally to determine whether or not you’re near ovulation, track when that ovulation occurs, and stay away from sex (or use a condom) within a certain time frame around ovulation. “Day 14” means absolutely nothing, because every woman’s cycle is different. You may very well ovulate on day 9, meaning that by day 14, if you’ve had sex, it’s already too late.
So how do you figure out when you’ve ovulated?
- Track your basal temperature every morning, the minute you wake up. You’ll be looking for a pronounced temperature shift (at the .00 level, which is why you need the basal thermometer), which indicates that ovulation has occurred.
- Monitor your vaginal mucus, analyzing its color and quality to determine when ovulation may be near.
- Check your cervix to determine its position.
When you get in the habit of knowing the three factors above, then you must abstain from unprotected sex until four days after ovulation has occurred. You can’t have unprotected sex before ovulation, either – sperm can live in the uterus for a while, so if you have sex three days before ovulation, there’s a chance sperm will still be around to fertilize the egg.
Sound complex? It is. And there’s A LOT more to it than I’m even listing here. Rules that help you play it safe and whatnot. If you’re interested in FAM, I fully recommend the book Taking Charge of Your Fertility by Toni Weschler. I’m also happy to answer any questions you may have – just leave them below in the comments or get in touch with me through my Contact page.
For what it’s worth, though I don’t use this method myself right now, I did use it for about three years and never got pregnant. But I was very diligent about tracking my cycle, I used condoms during the entire first half of my cycle, and I have very regular periods, which simplifies things.
A Short Aside, and My Own Story
I’d just like to close by saying that I don’t think any method of birth control is wrong. What works for you, works for you – and that’s amazing! I think that giving women the ability to choose when they do or don’t get pregnant is a crucial part of making a better world for everyone. I’m passionate about women’s options and the right to choose.
But, here’s my story: I took the birth control pill on two separate occasions (one of them being right now), and in both scenarios, I felt absolutely flat. Dead inside. Low on energy. Moody. Unattractive.
The first time I took the pill, I wasn’t yet aware of my body and the subtle differences in mood, libido and energy that came along with my use of the pill. It wasn’t until I went off it (I read Taking Charge of Your Fertility and wanted to go more natural) that I realized how off I’d been feeling. It was seriously like awakening from a long slumber. I suddenly felt clear-headed, more passionate, less moody and more balanced. And I will reiterate: I never realized how bad I was feeling until I stopped feeling that way.
I’m back on the pill again now, and it’s not my ideal situation. Sometimes, the situation calls for it, and I’ve made my peace with it for now. I don’t blame women who want that reliability. But the truth is, it doesn’t come without its drawbacks, and this recent news about alarming depression rates is serious business. It’s good to know that there are some more natural alternatives around, should you want to go that route.
If you’ve tried one of the methods above, I’d love to hear your story! And if you take hormonal birth control now – do you love it, or hate it? Let me know in the comments!