Hi Dr. Kate!
I can't take hormonal birth control; I've had terrible side effects and I just don't like it! My question is; what is the best non-hormonal option? My doctor will not give me an IUD because I've never been pregnant. How effective is coupling condoms with a diaphragm or the sponge? I've read that The Sponge increases the risk of contracting HIV, but I've been with the same guy my entire life, so I don't think this is too much of a concern for me. Thanks!
No Pills for Me!
Dear No Pills,
My first thought is...find a different doctor! There's no reason that you shouldn't be able to get an IUD before a baby, that's outdated thinking. And a copper IUD will give you 99+% effectiveness for up to 10 years, so it's hands-down the best non-hormonal option. Condoms plus a diaphragm should get you over 90% effectiveness, especially if you use spermicide with the diaphragm (available as creams, suppositories or film). And condoms plus the sponge should be about that good as well.
The sponge - like other spermicides - may increase your HIV risk if you're having intercourse, and using the product, multiple times a day, every day. (The studies that showed us this were conducted in sex workers in Africa.) Since this isn't the sex pattern of most people in the world, spermicides are still a good option, when used in conjunction with a barrier method (condoms, diaphragm) for greater effectiveness.
But my guesstimates on effectiveness are based on PERFECT use - using both products, every time, with no spillage. And that can be tough to do, long-term. I'd still think about seeing another gyno to get the IUD, then going back to your guy for your check-ups, especially if you know you don't want to be pregnant for awhile.
Have you been told you couldn't get an IUD? What was the reason?
Photo credit: Liz Henry