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Confuseddd asks:

I'm really torn on what to do. I'm a 17 year old, sexually active girl and I've been thinking about getting on the pill. My boyfriend and I use condoms every single time, but he wanted me to get on the pill because he says it feels better without one and also because pregnancy is something we both don't want. It took me forever to get up the courage to make an appointment at Planned Parenthood, and when I finally did, I canceled 5 hours before my appointment. I just couldn't go through with it. I think I want to get on the pill but I'm scared my mom will find out since I have to take it everyday, and I also don't want all of the side effects like mood change and weight gain. My boyfriend now says that I can do whatever I want, and that after getting used to condoms, he thinks that they feel the same as not using one. That's great and all that he's putting the decision completely in my hands but it also doesn't help because I have no idea what I should do. Is it okay for me to just use condoms? Is that safe enough, if we use them properly? Will the pill be too much of a hassle if I have to hide it, and does it really cause you to gain weight and get all sensitive? I don't know what to do at all. I want to be responsible with this but I just want to make sure I'm not choosing the wrong thing by sticking with only condoms.

Sarah replies:

From what you've said here, I'm not sure the pill necessarily sounds like the best option for you at this point in your life. The pill is a good method of contraception, but it isn't for everybody. As far as the side effects go, do understand that they're not guaranteed to happen for everybody. There are plenty of women on the pill who don't have weight gain (or don't have much weight gain) or mood changes. As well, the weight gain that can occur is usually related to water retention, which can be combated to some extent. You're right, it does need to be taken everyday (at at the same time each day), which is not a schedule that works for every woman. But if you don't want to deal with any of that, then the pill probably isn't the best idea for you. In terms of hiding it from your mom, we always recommend being honest with parents unless you feel that you are physically in danger by doing so. Parents usually find out what's up, and in the long run it's generally best to be open from the get-go. If you are wanting another method of birth control, you may want to check out our article Birth Control Bingo!

It is certainly up to you what methods of contraception you want to use and what level of risk is acceptable to you. If you do not want to use a hormonal method, then you do not "have" to do so. There are other non-hormonal methods available (like a diaphram or Lea's Shield) that you could use only when having sex and in conjunction with condoms to provide extra pregnancy protection. If you've had regular cycles for a while, a backup like FAM (fertility awareness) could be an option for you, though it does involve charting daily (and then abstaining completely during the fertile times you identify via your individual charts) and you must do it consistently and properly in order to have useful information. Condoms on their own do provide excellent protection when they're used correctly for all genital contact and do not fail (which you would notice if it happened). As your partner noted as well, condoms really don't change sensation to any great degree. They're a really easy and affordable and are the only method that provides STI protection (if you and your partner did decide to utilize another method and forgo condoms, we would suggest making sure you have at least 2 clear STI screenings each with 6 months of monogamy and condom use to help reduce your risk of STI transmission). No method of contraception is going to be 100%, outside of complete abstinence. By properly using two methods, you do further reduce your risk though. So to some extent, the question is what level of risk you are comfortable with. If you're alright with the effectiveness of condoms (failure rates of about 2% for perfect use and about 15% for typical use), then that's fine. You may also want to have some emergency contraception on hand (or at least know how you can access some) in case a condom does fail. However, if you are not okay with that level of risk, then you may want to consider either doubling-up on your methods (by using another non-hormonal method or a hormonal one) or by choosing not to be sexually active until you either are okay with the risk or you have access to methods that reduce your risk to a point at which you are comfortable. To find out more about the various methods available and their effectiveness, you can check out Margaret Sanger's Disneyland: Choosing Contraceptives.

So what do you do now? Well, first off you do have to decide what level of risk is acceptable for you and what YOU want to do in terms of a secondary method (if you want one). To some extent, it's an issue of weighing risks and benefits in conjunction with considering your lifestyle and what you want. Secondly, I'd encourage you to go ahead and make (and keep) an appointment with your sexual health care provider (whether that's your regular provider, Planned Parenthood, or some other clinic). When you're sexually active, it's crucial to be getting regular (annual, at the very least) sexual health care. This is important both in terms of having a place to talk about contraception with a professional and in order to keep you healthy. So if you make an appointment to see a provider, you can also talk with them about what forms of contraception they would recommend for your situation. Seeing a provider for a gynecological exam is not as scary as people sometimes make it out to be. I'd honestly rather have a PAP and pelvic exam than go to the dentist any day!

You may find it helpful to check out the following for more information:

Information on this site is provided for educational purposes. It is not meant to and cannot substitute for advice or care provided by an in-person medical professional. The information contained herein is not meant to be used to diagnose or treat a health problem or disease, or for prescribing any medication. You should always consult your own healthcare provider if you have a health problem or medical condition.

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