Birth control before & after DS

I am currently going for the DS. I am currently trying to find the "right" BC before my surgery to avoid pregnancy until Im far enough out from surgery. My question is, what did anyone else choose as BC before surgery?

PS- I dont relish the idea of an IUD

I'm in the same boat as you. I had originally decided to go with the Mirena IUD but later changed my mind when I remembered how painful cervical checks were during labor. I know that IUDs are inserted rather quickly, but I don't want anything inserted or anyone messing around with my cervix again, ever.

I've heard about Implanion (which, if I remember correctly, is a little bar thing they insert into your arm.) I've also considered getting the Depo Provera shot or NuvaRing. I'm leaning more towards NuvaRing since it is a "local" birth control and can easily be removed and stopped if need be, whereas the shot is irreversible, as there is no way to remove the medication once injected. I'm very apprehensive about Depo. I've heard a lot of horror stories about how the Depo shot made ladies gain weight, have horrible mood swings, and remotely led to near infertility. And, from my own personal experience, my sister took it at the time when she and I lived together, and it turned her into a royal, intolerable b-word. To each is own, though. What works for some doesn't work for others.

Also, make sure that you use a barrier method along with whatever birth control you decide on. Guys have it so much easier. For more options, you may want to check out this resource: http://www.dsfacts.com/Post-op-Birth-Control.html

I was on continuous birth control pills before surgery and am on that now. I don't take a week off from the pill to have that time of the month - I just supress it and it has worked great since the DS. I would however use a back up method until further out such as a barrier method just in case. The nice thing about continuous birth control pills is you don't have that time of the month and for me it keeps my moods MUCH more stable.   It's not for everyone though but it's an option.

Alecia

Be cautious.  Some DSers do not absorb oral BC sufficiently.  Especially during the early post-op stages when estrogen balance is so whacky anyway because of the rapid weight loss.  Use another method,  hormonal is fine,  just not oral.  Nuvaring for example,  Or injections.

Avoid Depo like the plague, please. 

Especially in DS'ers but as well in the general population, DepoProvera has been under increased scrutiny by ACOG (American College of Obstetrics and Gynecology) because it has been shown to cause a reduction in bone density, even in very young women.  They believe it is because of medroxyprogesterone induced estrogen reduction. 

Provera is the branded name and it is very widely studied, utilized, and derided in the medical community.  Lots of side effects.  There was a study that I read performed on Rhesus Monkeys that showed it acted as a vasoconstrictor and worsened heart disease.  Poor monkeys.  :(

Plus, in their pivotal trial, almost 40% of women gained more than 10lbs.  Sort of defeats the purpose.

An IUC, although not relished, is the way to go.  Either Mirena or ParaGard, depending on if you want hormones or not.  I know you're nervous about the insertion but I've had it done - honestly  it's nothing.  And, once it's in you forget it's there if it's inserted properly.  No pain, no exams or poking at your cervix. 

IUDs have many advantages, however, if somebody has never had children and would like to in the future,  the risk,  however minimal,  is just not worth it.

If you're concerned about injections....go with Nuvaring.

I have to respectfully disagree.  While Mirena is not indicated in nulliparous (no delivered children), ParaGard is but both are used extensively in that population.  No extra risk of PID or anything else that would make it difficult to have children.  Numerous studies on the IUCs show that 75% of women trying to get pregnant are able to do so within 6 mos of removal of ParaGard and with Mirena it is 80% at 12 mos.  Exactly the same as the general population and significantly shorter timeframe than those coming off hormonal contraceptives. 

Always discuss with your physician to see what's right for you though

I understand that statistically,  that's all true.  Still,  for someone who has never had children and wants to,  I feel the risk of uterine perforation,  even though small, is not worth it.

And coming off of oral contraceptives means frequently a shorter timeframe for pregnancy,  since FSH is suppressed and therefore artificially lowered.  In fact,  in infertility clinics,  oral contraceptives are frequently used for a cycle or two just prior to treatment.

True, perforation is very rare but not zero so I see your point.

Re: OCs in infertility clinics, they are only used for spacing cycles to harvest eggs.  They suppress and then have the patient come off the OCs and artifically stimulate the ovary to produce follicles which are then extracted for fertilization.   Lots of documented studies show longer use of OCs lead to a slower return to fertility.  It takes a while for the long-supressed ovaries to "wake up".

Now I must tell you that I work in the field of infertility,  and I myself did 12 or so IVF cycles.  You are incorrect that OCP's "suppress" the ovaries.  In fact OCPs are used immediately prior to stimulation cycles.

This is from the website of one of the leading IVF clinics in NYC.  It's a good explanation:

"Some of our patients are given OCPs to regulate their cycles. Oversuppression is not a concern, because once FSH starts to stimulate antral follicles, the follicles will grow. OCPs may just slow down the response time. Also, OCPs serve to suppress the ovaries prior to the start of a cycle, making it more likely for follicles to develop together, rather than create a dominant follicle which will be ready for ovulation before the other follicles have a chance to mature. In order for an egg to develop in the ovary and then be released, several hormonal events must take place. An area of the brain, called the hypothalamus, is responsible for regulating the hormonal signals that start the process. The estrogen in the pill shuts off these signals from the brain that tell the ovary to develop and release an egg. Without these signals, the egg does not develop and is not available to be released (ovulated) and pregnancy cannot occur. In addition, the pill has a few other effects on your body that decrease the likelihood of pregnancy. One of the hormones in the pill, progestin, makes the mucous thicker in the cervix and tubes so that it is more difficult for sperm to pass into the uterus and more difficult for the egg to move down the tube. Also, the progestin in the pill causes changes in the uterine lining that hinder implantation of the fertilized egg. When used in the fertility setting, the pill's ovarian suppression characteristics serve to "quiet" the ovaries. This is meant to allow a stimulated cycle to begin with all of the follicles at the same stage of development. Hopefully, this prevents a "lead follicle" from developing, increasing the chances of having more follicles mature at the same time. BCPs do not negatively affect fertility. There is no evidence to indicate that BCPs have anything but a short term effect in the body. If someone has been on the pill for an extended period of time, there is no reason to wait after stopping the pill in order to begin fertility treatment. In fact, it is advantageous to begin a stimulated cycle immediately after stopping the pill. Many people express concern about "over suppression" with the pill. In some women, the pill has a more suppressive effect than in others, but the only result of this is that it may take some more time for the hormone levels to reach the point where stimulation becomes effective."