Dear Dr. H,

I have experienced severe emotional “swings” while being on Depo [Provera]. Would a non-hormonal birth control option be a better choice? Is weight gain a myth when it comes to birth control?

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Dear anonymous,

Emotional “swings,” as you say, are terrible no matter the severity, so if you’re sure your birth control is the reason why you’re experiencing these, I would suggest doing what you can to find another contraception option.

Often, when we speak with our medical provider to discuss birth control options, or changing methods, they ask about other issues that may also be affecting your mood (and weight, which I will get to in a minute).

Are you taking any other medication that could be the culprit of such swings? Have you experienced any other traumatic or stressful events that could also be affecting your emotions?

If those aren’t the case, and the onset of your severe swings coincided with starting (or within several weeks of starting) Depo-Provera, then I think you should speak your provider about a different contraception methods.

Many women choose Depo-Provera, a shot given in either the arm or the butt, because it is a safe and effective birth control method that lasts for three months. For people who aren’t into taking a pill every day, this can be a great option.

Side effects, such as a change in sex drive, breast soreness, headaches, depression and weight gain can occur in users of hormonal birth control methods. However, this doesn’t necessarily mean you should steer away from hormonal methods, such as the Mirena IUD or birth control pills. IUDs (a device inserted into the uterus to prevent pregnancy) can be used – and are recommended for use – long term.

So, if you choose another hormonal method, your provider may suggest a birth control pill because if you do experience side effects, you can stop taking the pill immediately and find something else. Non-hormonal methods, like condoms or ParaGard IUD (“copper T”) do not interfere with your body’s hormones and may be a better option.

Condoms are great, safe and effective for pregnancy AND sexually transmitted infection prevention – bonus! But, you have to use them correctly and consistently for them to actually be effective. The diaphragm, a dome shaped, rubber rimmed cup that is inserted into the vagina prior to sex (up to six hours), is another non-hormonal option.

Like condoms, however, planning is key. So, if you’re uncomfortable with carrying condoms and requiring their use with partners OR if you’re uncomfortable excusing yourself to the restroom mid-make out session to put in your diaphragm because you didn’t plan ahead, these options may not be the best for you.

Vaginal spermicide, contraceptive sponges, cervical caps, Lea’s Shield (similar to the diaphragm) and female condoms are all non-hormonal methods that need to be thought about and inserted prior to sex.

So, no matter how effective these methods are, and no matter their absence of side effects, a birth control method you don’t feel comfortable using is not the right choice for you. The ParaGard IUD is also a safe and effective non-hormonal method for pregnancy prevention (but does not protect against STIs).

IUDs, again, are usually recommended for people who wish to prevent pregnancy for several years, and their use does not require the pre-plan like the methods noted above.

So, a bit about the weight gain “myth”: not a myth. Weight gain is often cited as a side effect for hormonal birth control methods. That being said, many users do not experience any weight gain, so don’t let the concern of weight gain as a side effect prevent you from choosing an otherwise viable birth control method.

I recommend visiting your provider to discuss your options further – if you don’t feel comfortable discussing your sexual history and contraception needs, or don’t feel like you’re being heard by your provider, get a different provider! Also, remember that Planned Parenthood is available right in town and can offer a variety of contraceptive – both hormonal and nonhormonal – that should fit your needs.

Good luck!