Zero Waste Contraception???

Talking about sex 👉👌, contraception 🚫👶 , and menstruation 👹🍓🍅 still is something you are supposed to do behind closed doors or in a controlled and contained environment like sex ed class or THE TALK *pause for dramatic effect*. Chatting about it in a café, restaurant or even the subway will most probably earn you weird looks. Oh, and of course it is supposed to be awkward as hell, with a lot of stuttering, blushing, giggling and uncomfortable silence inbetween.

So let’s get uncomfortable. (Or not.)

Personally, I find the taboo surrounding these topics ridiculous. Come ON, people, it’s 2016, and these are topics that everybody needs to deal with. Yes, everybody! I do strongly believe that also the part of the population not having to menstruate (and I am born female and one of these people as I will explain later on) should know and be educated about what it is like to be on your friggin period! And having to ask for a tampon should not be something embarrassing, but normal. Because, well, it happens all the time. To 50% of the population. Just saying.

Anyway, today isn’t about aunt Flo, but about contraception. We’ll get to the period talk later, I promise 😉. I do apologize in advance for this long article. Contraception is a topic I believe most of us are not too well informed about, even though we all have sex. So even though I will focus on the Zero Waste aspect, I will also cram in a lot of information. Watch me unleash my inner eco sex ed nerd LOL 😝!

What is “green” about contraception in general

Every human being uses up a loooot of resources, and being able to plan pregnancies instead of – oopsie – having them happen helps a lot in slowing down the population growth.


An important and personal note on the most popular forms of contraception – the birth control pill and condoms!

The most popular methods of contraception in the U.S. and Europe are still the birth control pill and condoms. Both, however, really are not the safest options when it comes to contraception; with a pearl index (= failure rate in 100 women using the method for one year) of 0.1-0.2 for the birth control pill and a whooping 3-5 for condoms – if correctly used!

Also, let’s not forget about the failure rates for both methods of contraception! I have had condoms tear during sex – screw the hitchhiker’s guide and start to PANIC !!

Personally, I would recommend everyone to NOT rely on condoms as the only contraceptive, but to use condoms additionally when needed as a measure against STDs (sexually transmitted diseases)!

And don’t get me started on all the ways you can screw up taking the pill! It is just too easy to forget to take it every day at the same time! Once you forget to take the pill the protection is out of the window for the rest of your circle! Diarrhea and even partying, too, can throw your body off schedule.

You have a higher risk for serious blood clots by about 3 to 4 times, which is even worse if you happen to smoke! A friend of mine (non-smoker) had a sports-related injury and couldn’t move her foot for a couple of weeks. This led to blood clots forming in her foot that travelled all the way up to her lungs and cut off the blood circulation to her lungs. None of the doctors she went to suspected blood clots because she was only 28. One morning, she stopped breathing, and was resuscitated after maybe 10 minutes. Today, 8 years later, she is still severely disabled – both physically and mentally. She was on the pill. And I was the last person at her side before she had to be reanimated the next morning. Just so you know, I have changed her adult diapers multiple times after.

Anyway, other risks include strokes, heart attacks, and high blood pressure, again, worse if you are a smoker or over 35. So do I think taking the pill is the best contraceptive option? HEEEELL NO!!!

I don’t think I even need to point out the amount of non-recyclable trash condoms and the blisters for the birth control pills generate. Personally, I do not see why anyone should take the pill when there are better options out there. Condoms, at least, prevent STDs and do not pose a health risk per se.

Now, is there a Zero Waste alternative to condoms?

I’m sorry to say this, but no. And I strongly believe you should use condoms to prevent STDs (as I said – condoms are not very reliable as a contraceptive) when

  • having a one-night stand, or
  • multiple or quickly changing sex partners, or
  • you or your newly found partner in crime have not been tested, regardless of how much in love and serious you are.

Seriously, just get get tested for STDs before having sex without a condom. I swear, it’s not a big deal. My husband and I did it before we ditched the condoms. We were young (20 and 21), so we went in fully prepared for weird looks. Instead, the receptionists were super discreet and the physician praised us, telling us he wished more young people would be as responsible. I’m sure that is what all physicians think, so there really isn’t anything to be ashamed of!

I don’t think there will ever be a zero waste alternative to condoms, but only because there are situations you should still use condoms it doesn’t mean you cannot go for the most sustainable option!

There are brands out there that produce sustainably, honor Fairtrade, and make sure their condoms are made from natural ingredients and vegan. If you live in North America, you can go for Glydeamerica, if you live in Europe, there’s Einhorn (trans. unicorn) condoms.

Isn’t withdrawal/the pull out method/coitus interruptus a very Zero Waste contraception?

Nope, withdrawal is NOT a method of contraception at all! Do go for it if you don’t mind getting pregnant though. Oh, and like everything else that isn’t a condom it does not prevent the transmission of STDs.

Is there a Zero Waste alternative to the pill?

Oh yes, there are multiple alternatives, if you want to stick to hormonal contraception. None of the hormonal methods are completely waste-free, but the amount of waste you generate does vary a lot. However, they are all more effective when it comes to prevent pregnancy and less of a hassle. In my humble but loud opinion, the pill really is among the worst choices when it comes to either contraception, user-friendliness, health or trash.

Warning

Do keep in mind though, that most contraceptives that also combine the hormones estrogen and progestin do pose the same risks as the pill (i.e. serious blood clots, strokes, heart attacks, high blood pressure) and should especially be avoided if you are a smoker and/or over 35 years old.

The birth control ring – estrogen + progestin, 1 month protection

The birth control ring is a ring you insert into your vagina, where it stays for three weeks. You take it out, get your period, and insert the next ring. It contains the same hormones as the pill, so you get all the risks you get with the pill. However, it rules out a lot of common user mistakes that comes with using the pill.

Would I use it? No, I wouldn’t, because it is pretty much the pill jammed into a ring. Even though inserting it in the vagina make it appear as if the hormones only effect that area this is not true. Thus, it is only a very slight improvement to the pill in my humble opinion.

Trash count

Not sure it’s a lot less waste than the birth control pill, but I do believe it is the smarter short-term option though.

Birth control shot – progestin only, 3 months protection

Unlike the pill and the ring, the birth control shot only contains the hormone progestin. No estrogen usually means no increased risk of serious blood clots, strokes, or heart attacks. However, according to a study birth control shots seem to be an exception when it comes to the increased risk for serious blood clots at least.

There are also side effects like migraine headaches, irregular bleedings, lighter periods and after one year most women do not get their period at all, which may or may not be perceived as desirable. Oh, and you definitely shouldn’t go for it if you have breast cancer.

If you get the shot within the first five days of your period cycle it will take effect immediately. Any other time means you will wait a week until you can be sure it will prevent pregnancy. You will have to re-new the shot every 12 weeks, but until than you don’t have to do anything at all.

Trash count

Every time you get a shot, the doctor or nurse needs to wear single-use gloves, the syringe as well as the flask that holds the substance are also single use. So does this method generate less waste than the pill? Probably not. But again, it is a smarter choice compared to the pill!

Contraceptive implant – progestin only, 3 years protection

Now we’re getting into the long-term contraceptives, and thus entering the a-lot-less-waste and worry-free zone, as I like to call it. The contraceptive implant is a progestin-only matchstick-shaped rod that is inserted under your skin into the upper arm. It is said to be the most effective birth control method, but side effects include irregular bleeding patterns, drug interaction, possible weight gain, and migration of the implant. Like with the birth control shot the period gets lighter and might stop completely.

It is not associated with serious blood clots, but it is still advised that women who have or had blood clots shouldn’t go for the implant.

Trash count

I don’t know how the box looks like, but since you only have to get it inserted once in three years, it is bound to produce a lot less trash. Of course I expect the gynecologist or nurse to wear single-use gloves. They should to prevent infections.

Hormonal IUDs (Intrauterine Devices) – progestin only, 3 or 5 years protection

Here we go, this is what I have been using for the past 12 years (OMG, I’m already on my third IUD ). Please don’t get me wrong – I HATE having to put my body through all that comes with hormonal contraception. However, back when I started it was the only method that made sense. If I were a 20 year old today I would definitely go for the copper coil/ ParaGuide IUD (see below), but back then a copper IUD was only an option for women who had given birth. Well, after more than one decade of straining my body with hormones the switch wouldn’t have been an easy one (hubby and I did talk it over with my gynecologist).

So the hormonal IUD is a device that is inserted into your uterus. Nowadays even young women or sexually active teenagers who haven’t given birth yet can have IUDs. In fact, in Germany where I live, 3 year hormonal IUDs are said to be the better option to teenage girls compared to birth control pills. First of all, user mistakes are completely ruled out. And secondly, it is the hormonal contraceptive with the fewest effects on your entire body, since there are only tiny amounts of hormones seeping into your blood circulation. It also releases the smallest amounts of hormones over all, as my gynecologist told me. As you can imagine, a growing teenage body shouldn’t be pumped with hormones. So there you have it, the reasons why I went for the hormonal IUD 12 years ago at the age of 20. Before that I was on the pill, which considering my slightly excessive party life back then might not have been the best idea.

I went for the 5 year instead of the 3 year IUD (mine is called Mirena) because I was very very certain I wouldn’t want any kids in the upcoming five years (at least) and didn’t want to have to go through a painful removal and re-insertion. After the first insertion I had irregular bleedings for about 6 months and eventually my period just faded out until today. I also had cramps for two whole weeks, which is quite the exception though. I know other women with IUDs who only had cramps for the first couple of days, which is rather normal. After the insertions of the following two IUDs I didn’t have single symptom, since my body was already used to it.

So how do I like it? Well, I don’t actually miss aunty Flo. I do get very light period symptoms from time to time – pimples, sometimes very light cramps, maybe a hint of a bleeding or swollen/tender breasts. This is because unlike when you are on the pill, your body still has a real cycle. (The pill tricks your body into thinking it’s pregnant in order for your body to stop ovulating) I only get these symptoms when I’m overly stressed though.

I will not lie to you: removal and insertion of the IUD hurts like hell. Luckily, it only takes 1-2 minutes. And then again, shots hurt, getting the implant does too. And I’d rather endure the pain than expose myself to the risks that come with the pill or the ring. You can choose to have an anesthesist knock you out cold, but a general anaesthesia comes with a lot of risks and should be avoided where not necessary.

Trash count

My IUD came in a surprisingly big box considering the fact that it is a teeny tiny device! However, it is still an amount that would still fit into our trash jar. My gynecologist did wear single-use gloves, but that is it. I also do not need any period helpers like tampons/moon cup or pads. I do have three washable cotton pads because I do get spottings, but I only need one every other month.

OK, but what if I don’t want to burden my body with hormones??

Oh, I feel you! Go for it, girl! It is definitely better to not manipulate your body with additional hormones. Just know that this, too, comes at a price…

ParaGuard IUD/copper coil – hormone-free, lasts up to 12 years

Copper IUDs used to only be an option for women who have already given birth. This is not true anymore. IUDs have become smaller, and there is now a version called GyneFix copper coil that is said to be even more suitable for young women. However, it seems like it is pretty unknown outside of Germany?

Do keep in mind though that copper IUDs may lead to increased and longer menstrual bleedings – and more painful cramps! Outch!

I know, choosing between drugging yourself with hormones for years and years and ditching hormones but putting up with an angry aunt Flo each month does sound like the choice between the devil and the deep blue sea.

Trash count

If you go for the 12 year copper IUD you will save a LOT of trash. Of course the gynacologist will have to wear single-use gloves for the insertion and the IUD will come in some sort of a box, but that is a one-time thing.

Vasectomy or Tubal Ligation (male and female sterilization) – for the rest of your life

You need to be very certain you don’t want any kids (anymore) because it is a permanent procedure that will basically render you infertile.

So this is finally an area where the man can and should step in! A Vasectomy (male sterilization) is very simple procedure and only takes 30 minutes. A tubal ligation (female sterilization), on the other hand, is a major surgery where the person has to be put under general anaesthesia.

I’m not a fan of The Doctors TV show, but this one they do explain beautifully!

Did you know a vasectomy is basically the only male method of contraception? Well, I don’t count condoms because they are more for STD prevention than contraception anyway.

Trash count

Both vasectomy and tubal ligation are one-time procedures. I have no idea whatsoever of what disposables are medically needed, but I am very certain these one-time procedures generate less trash than taking the pill on a daily basis.

Fertility awareness

There are multiple methods to determine fertile and infertile phases of a woman’s cycle. The idea is that the female body gives off signals to indicate at what stage of the cycle it is: the body temperature, the consistency of the cervical mucus, as well as the cervix itself change. By checking and combining these “symptoms” and learning about the own cycle it is possible to detect the fertile phases, during which either condoms are used or abstinence is practiced.

However, these methods are not very effective compared to all the other methods in this article. Moreover, they rely heavily on discipline and a very regular daily routine, which means they are sensitive to changes in these routines. Just catching a cold, a night out or getting up earlier or later can literally throw off your charts. Also, you need to collect data for months before you can actually put it to use. These methods seem to be more effective when it comes to wanted pregnancies compared to preventing pregnancies.

Trash count

The only method that can be done completely zero waste. You only need a thermometer and you are good to go. There are mobile apps nowadays so you don’t even need to use the sheets anymore. There are even small computers out there to help you with it.

Conclusion

The long-term methods (implant, hormonal or copper IUDs, or sterilization) are not only greener, but also healthier and more effective. Condoms should still be used whenever there is an STD risk, but do go for the more sustainable versions that are vegan, fairly produced, and without any chemicals and toxin-free.

A penny for my thoughts: Who should pay for contraception?

12 years ago, when I got my first IUD, my now husband, but then very new boyfriend insisted on paying for it, even though I suggested we split the costs. We were college students with a monthly budget of not even 600 EUR (673 USD) each – for everything, including rent, food, tuition! Well, the IUD had a price tag of 300 EUR (336 USD – surprisingly it had the same price tag when I got my last one ten years after this first one!). I remember how I asked him how we would handle it if we broke up. Should I “buy him out”? He said: “You have to risk your health and live with side effects, so the least I can do is to pay for the damn thing, regardless of whether or not we split up.” And you know what? It made perfect sense and I still agree to this day. Not that it’s about the money, but I think splitting the costs 50:50 just isn’t showing appropriate appreciation for what women have to do to their health. Sadly, contraception is still widely viewed as the woman’s responsibility when it takes two to shag.

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12 Comments

  1. This is a fantastic post!

    I’ve had a copper IUD for years, though I’m on the pill for my acne problems… I’m totally new to the world of Zero Waste, but my acne meds are the things I’m most worried about giving up.

    It’s adorable that you’d even think to buy your then-boyfriend out of his IUD investment. Adorable! You two seem like an incredible team.

    • I think it’s ok to put off difficult tasks like that though XD. I mean, start small with easy things, right :)? I always compare it to a video game – you start at level one and work your way up LOL.

      And, um, yeah, I was serious, I would have bought him out XD. We do make a great team, even better today than back then 😉

  2. Hi Shia, interesting post! I thought I’d share my experiences too. I had a Mirena coil too (in the UK ,they are free!) and whilst it worked, I never liked the idea of the hormones and found the lack of periods (whilst still getting period pains and bloating) rather disconcerting! (When I took the pill in my early twenties, if I didn’t take at exactly the same time every day, I would throw up. Not a fan of hormones!) When it was time to remove the Mirena (5 years), I decided not to get another. PS I agree completely about the ridiculous box, and the even more ridiculous pain – woah! Now I use an app to track my periods called OvuView (available on Android, and really good). I’ve always had very regular periods which help. It also tracks other symptoms including how your mucus changes – which is an effective visual test. Plus I have this funny thing called “Maybe Baby” (I got it second hand – it’s about the size of a lip balm and has a light bulb and a battery). It tests your spit and can indicate when you’re ovulating. I find the two together work for me – but like you, I’m married too so STDs aren’t a concern.

    Hope that helps and adds to your article! : ) Lindsay x

    • Thanks so much for sharing, Lindsay <3!! You know, I do sometimes wonder how I'd be without hormones... I have been taking hormones for so long now (15 years...!!), I really have no idea :(. It's so sad when you think about it! So happy for you that the "Maybe Baby" (what a name XD) + OvuView works so incredibly well for you! My husband has brought up a vasectomy ("snip snap" – his words, not mine LOL) again and we are considering it. We'll see LOL.

  3. You have a picture of the caya diaphragm but don’t mention it in the article. It is a fabulous option/

  4. Anima Sola

    One actually doesn’t have any cycle on hormonal IUDs like Mirena, just like other hormonal contraception. And it’s more like it’s tricking your body to think you’re menopausal than pregnant. This is the reason women lose their periods – a period is a result of ovulation, and a woman isn’t ovulating. Though even having a period on the pill is not a real period but withdrawal bleeding from the hormones in the pill – this is why it’s incorrect to say that artificial hormones regulate the cycle when they really make sure there isn’t one. Having a period serves no function when one is taking hormonal contraception but the doctors decided to “give” women a fake period when designing the pill because it helped make it legal (branded as “normalizing cycles” rather than contraception), and still having a period made women feel more comfortable with taking contraception. You only still have your cycle when having a non-hormonal IUD like Paragard, but it basically functions by making your reproductive system constantly inflamed and comes with risk of copper toxicity, which is as bad for your body as are the hormones. And lastly, not having a cycle isn’t good for your whole health – we need those natural hormones. This article explains it well… https://www.usa.daysy.me/blog/5-good-reasons-to-have-your-period/

    About withdrawal… When done right, it’s actually about as effective as condoms – 96%. It gets a bad rep because many people don’t practice it correctly. These are the rules of perfect withdrawal use:
    1) The man urinating before and in-between rounds. Also washing his genitals before going for another round. 2) Withdrawing way before the actual ejaculation. 3) Ejaculation far away from the vulva/vagina. 4) Washing off everything that came in touch with semen (e.g. hands) immediately after an ejaculation to ensure there’s no accidental transmission of semen back inside the vagina. 4) Great communication is very important because partners should be on the same page and only use withdrawal when the man can tell the woman easily if he did it right or not. https://bedsider.org/features/310-5-myths-about-pulling-out-busted

    Lastly, I don’t think you give fertility awareness method enough credit. It is a highly effective method that is scientifically researched (recent Sensiplan studies done on thousands of women show 99.6% effectiveness with perfect use and 98.2% with typical use, which is more effective than the pill: http://www.fam-sensiplan.com/uploads/4/1/7/3/41734997/effectiveness_study_of_fab_method_frank-herrmann_2007.pdf). It is often confused with the rhythm method which requires very regular cycles and makes assumptions according to previous cycles – FAM works by calculating fertility in real time, adapted to the current cycle, which is why it can account for different cycle lengths. The mishaps you mention very rarely happen because women are aware what throws their readings off and take that into account when interpreting their cycle and always stay protected when rules are not met. And a certain amount of knowledge and routine is important in all other birth control methods (even with IUDs you are supposed to check the strings every 3 days). FAM really doesn’t take too much time once one gets into it… A few minutes in the morning to measure the temperature, and then a few more during bathroom breaks to check the fluids (and cervix). I see it as an investment into the health of myself and the planet.

    For those who don’t trust themselves with these signs, there are thoroughly tested, medically certified devices with sophisticated algorithms that analyze your cycles for you and boast a 99.3% efficiency (Daysy, LadyComp) and 99.5% efficiency (NaturalCycles).

    And yeah, you didn’t go into another hormone-free method – the diaphragm (Caya is the one pictured). At 94% perfect use and 84% typical use, they are admittedly a bit less effective than condoms, but used along with withdrawal, they can be a safe alternative when not abstaining during the fertile days of the cycle. Of course, there is no STD protection, so condoms are still needed for that.

    Hope this clears up some things!

    • I agree with your comments on Fertility Awareness Method. I have wildly irregular cycles and am highly fertile (conceived on first cycle of trying with all 3 of my kids) and have been successfully using FAM to avoid pregnancy for over 5 years now.

      The whole reason why it works so well is that you go by day to day signs and symptoms, not past history.

      It’s super simple to use correctly and not time consuming at all. I don’t even need paper anymore. I chart on an app on my iPhone.

    • Anima, I totally agree with your comment! Anyone interested in learning more about various methods of birth control, Fertility Awareness (FAM) and charting for health reasons should read Taking Charge of your Fertility by Toni Weschler (http://www.tcoyf.com/). It totally changed my life. You can also combine FAM with condoms or other barrier methods.

  5. Thanks for writing such an informative post, and for sharing your honest opinions. I had to have my IUD (non-hormonal) removed recently after having it for 2.5 years, because it caused me SO much pain. Every time I needed to poo, it would hurt like hell and my periods were awful. I came across this post as I’m looking for an alternative. The only one that 100% fits into my lifestyle is sterilisation, and as I don’t want children, I think it would be perfect. At 25, though, I still might want kids, so I don’t know what to do…! Argh!

  6. I had the copper IUD for a year and loved it! True, more intense bleeding and cramping than I ever experienced, but I got better at dealing with it (avoiding coffee and eating mostly raw made a big difference on the days before my period) and it was only 1 day every month. Sadly it moved in my body and had to be removed, which is very rare, aren’t I lucky!? It really seemed like the perfect birth control in every way.

    Pills made me crazy, and now I am on the nuvaring and it’s awful. I have crippling headaches, nausea, no desire for sex, don’t feel like myself at all…it’s awful! Can’t wait to take it out this weekend. I’ve read a lot now on hormonal birth control and so many women have talked about how they feel like a new person after coming off it. I Know I will never put myself and my partner through this again! I’m scared of the fertility awareness method especially as it is a lot of work, but it also seems empowering to take matters into my own hands for once. If used correctly it can be 98% effective, which is better than condoms, lol. Anyway great post, still not sure what I’ll end up with, but thought I’d share my experience with the IUD in case anyone else here is interested. It was great while it lasted!

  7. Thank you for your very thoroughly researched post. This is one area I really struggle with. After being on the pill for years and never having a period (seriously how weird is it that I NEVER had one normal period in three years!) I decided that hormones weren’t for me. I know a lot of women don’t take issue with this and I don’t judge them, I just know when I went off the pill and my period returned every 26 days like clockwork, I was relieved to know my body was still functioning as it should. Now I marvel each month at the precision of it all. I’m married, and I track my cycle carefully to be aware of when I’m fertile, and my husband and I use condoms based on when I’m ovulating. I hate the waste that they create, but I feel that it’s a sacrifice I can make in order to prevent adding more people to the already overburdened planet. I know that IUDs are a great option for a lot of women, and that’s awesome! Yay modern medicine! They’re just not an option for me, and I’m sure there may be others who feel the same. If we can’t save waste by not using condoms, at least we can feel good about not contributing to the world’s population.

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