Over the last 10 years, I've used five different types of birth control: two types of pills, condoms, Plan B and, most recently, an IUD. Given that I'm only 28, birth control is probably something I will have to think about actively for the next two decades, and I'm not unique. Yet women's "sagas" with finding contraception that works for our lives and bodies is something most of us rarely speak about in-depth.
Deciding how to control one's reproductive health involves a lot of factors: accessibility of said birth control, finances, convenience, menstrual cycle, how sensitive your body is to hormones and/or to latex... the list goes on. Finding the right birth control involves a whole lot of bodily trial and error.
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Taking ownership over your own reproductive choices can be incredibly empowering. It also can be exhausting knowing that there are politicians who are actively working to restrict access to birth control and slut-shame the women who use it. And that's a whole lot of women.
According to the Guttmacher Institute, as of 2015 there are 43 million women in the United States who are sexually active but do not want to become pregnant. And of women between the ages of 15 and 44 who have had sexual intercourse, more than 99 percent have used at least one method of contraception. Sixty-two percent of women who are of reproductive age currently use some type of birth control.
And while birth control is most often used to, ya know, control birth, many women also use it to regulate painful menstrual cramps or conditions like Polycystic Ovarian Syndrome.
Almost every woman has a story about birth control, whether she's been on the same contraceptive pill for 15 years, or tried the Patch for awhile and then opted for the withdrawal ("pull-out") method and condoms, or doesn't sleep with men at all and only uses the pill to regulate her menstrual cramps. Or maybe she got an IUD after having children and now has gone through menopause. These are the stories that we rarely hear about, but wanted to explore.
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I started by telling my story. Then we asked women to let us into their homes and allow us to photograph them with the contraceptive method they use right now. Fourteen of them agreed.
All photographs by Damon Dahlen
"With the IUD, for the first time I feel completely in control of my reproductive health."
Damon Dahlen/Huffington Post
I first went on the Pill (Yaz) when I was 18 and living abroad. I also started to get chronic migraines when I was 18, and those migraines got especially bad around my period. Eventually my doctor suggested that the hormones in the Pill might be making the migraines worse, so I switched to a progesterone-only pill, but that caused other negative side effects. When I was 20, I went off the Pill completely because I was just so exhausted with the whole thing, and depended on condoms and (very occasionally) Plan B until I was 27. Then I started hearing more women I knew talk about the IUD, which somehow had never been suggested to me. I spoke to my gynecologist and got the Mirena IUD 9 months ago, which will last for five years. My insurance covered the cost, and it’s been awesome. With the IUD, for the first time I feel completely in control of my reproductive health. --Emma, 28
"My concern about the effect [hormonal] birth control would have on me was overwhelming -- so I tucked the idea away and relied on condoms."
Damon Dahlen/Huffington Post
I don't take any form of [hormonal] birth control and never have. Growing up, friends and peers described side effects from the Pill that were more than off-putting to me. My concern about the effect [hormonal] birth control would have on me was overwhelming -- so I tucked the idea away and relied on condoms. However, as I've gotten older, taking birth control has become more of a frequent thought but I'm so buried in worry, I'm not sure where to start. --Lilly, 24
"I remember immediately feeling like something wasn't right -- I felt moody, abnormally sensitive and depressed."
Damon Dahlen/Huffington Post
The first birth control I took was Yaz when I was 18. I used birth control pills and condoms. I remember immediately feeling like something wasn't right -- I felt moody, abnormally sensitive and depressed -- but doctors told me to wait three months to see if I adjusted. I didn't, so I decided not to go back on the Pill until a few years later. After that, every birth control pill I've taken hasn't affected my moods, thankfully. I have had to switch to higher doses just to make sure my period stayed regular. I've also had to take the morning-after pill (Plan B), which is never fun. It doesn't sound like a big deal, but taking a pill every single day at the same time can be tricky. Most days, it's not a problem, but I've had times where I've forgotten to bring my birth control on weekend trips and things like that -- and that's just the worst. It's definitely empowering to have (relative) control over my fertility, but it can be a burden sometimes when all of the onus is on me and not my partner. That said, I don't know if I'd ever be able to trust a partner with taking a pill every day, so I'm glad I can control that. --Rebecca, 26
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"I still take the same kind of pills I started with."
Damon Dahlen/Huffington Post
I started taking Lutera birth control pills when I was 20. I got them at the Student Health Services center at my college. I still take the same kind of pills I started with, four years later. I didn’t have any bad side effects. I got my period when I was 11, so I had really painful cramps most of my life and since taking the Pill I don’t really anymore. --Caroline, 24
"It's incredibly liberating to finally be able to trust my body and be in sync with the natural rhythms of my cycle."
Damon Dahlen/Huffington Post
I started taking [birth control pill] Yaz when I was 19 and first dating my college boyfriend. It did the job, but not without a cost. The Pill caused my formerly normal periods to become erratic and frail, often arriving nearly a week late and lasting barely two days. Around the same time, my moods took a dive and I started experiencing more anxiety. I suspected it was because of the Yaz, but it was difficult to tell since there were so many other changes going on in my life at the time. It took a long time for me to work up the courage to quit the Pill for good. I had heard horror stories about the hormonal transition, and two failed attempts at ditching Yaz left me with breakouts and mood swings so bad that I felt I had no choice but to go back. Last year, I finally took the plunge for real and now have been pill-free for nearly 11 months. The difference in my cycle (not to mention my mood) has been night and day. For the first time in nearly seven years, I have healthy, regular periods, and I feel more positive and even-keeled than I have in a long time. To prevent pregnancy, my boyfriend and I practice Natural Fertility Awareness. I track my period using an iPhone app, and then use either condoms or the withdrawal method based on whether I'm at a fertile or non-fertile point in my cycle. At the risk of sounding totally granola, it's incredibly liberating to finally be able to trust my body and be in sync with the natural rhythms of my cycle. --Carolyn, 26
"I’ve changed pills three or four times because of negative side effects."
Damon Dahlen/Huffington Post
I first started using the birth control pill at 19 when I was living abroad in Israel because I had long periods and terrible cramps. Since then, I’ve changed pills three or four times because of negative side effects: weight gain, cramping, things like that. I ended up going off of the Pill for about a year, and then once I was better educated and had spoken to more women about their experiences, I went back on a different pill that had a lower dose of hormones, which was great. Once I left college, I wasn’t on my university's health insurance anymore and that pill was no longer available to me, so I went on the generic version. Since then I’ve switched pills twice more -- every time I’ve switched jobs and therefore insurance plans. --Adina, 27
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"Along with my anti-anxiety medication, it's been a godsend in helping to regulate my moods and health."
Damon Dahlen/Huffington Post
I started on [the birth control pill] Yaz when I was a teenager -- maybe 18 or 19. I hadn't had sex yet, but I'd been suffering from dysmenorrhea since my early teens -- almost fainting, stomach pains so awful I'd miss school, the whole thing. My sister and I found out that we both have a hormonal imbalance that means our periods are especially bad, so we got our prescriptions around the same time. I'd been on the Pill for a couple of years when my younger sister had a pulmonary embolism when she was 18. It was a mix of a lot of things with no warning signs, but a big factor for her was being on the Pill. She was hospitalized for a while, and she almost died. She can never go on birth control again. It's one of the most frightening things that's ever happened to my family. Even though my doctor said I wasn't at risk for the same kind of clotting, I went off the Pill in 2012 -- I'd been taking it sporadically anyway, because I was so nervous. I went back on the Pill (Lutera this time) for good in 2014: I've been in a steady relationship for two years, and we were using condoms, so it just made sense. But my main impetus was still regulating my dysmenorrhea. And it's free now, thanks to Obamacare. I started dealing with my anxiety and depression more actively around this time, too, and birth control pills really help with my moods. Along with my anti-anxiety medication, it's been a godsend in helping to regulate my moods and health: I don't have to miss work because I feel weak or in pain, or be laid low by stress or depression for days at a time. In that way, I feel better now than ever. (Also, my skin looks great.) --Megan, 26
"Who knew there were perks to menopause?"
Damon Dahlen/Huffington Post
I started taking the birth control pill at 17 when our family doctor asked if I was sexually active. I continued taking the Pill after going away to college and I got it through Planned Parenthood. I switched to the Norplant after the birth of my two daughters and just prior to moving to Saudi Arabia. We were there for a year because of my then-husband’s job and I was unsure if birth control of any kind could be found. Now I am not using contraception because I can no longer get pregnant. Who knew there were perks to menopause? --Melani, 54
"I had my 'tubes tied' after having my children. I no longer have to worry about any of the pregnancy scares, although I still need to use the pill to regulate my cycle."
Damon Dahlen/Huffington Post
I started using birth control (an IUD) at 21. I ended up having to remove the IUD because of bleeding and pain issues. After that I did not use birth control again until I was 23 years old, at which time I started using the Yasmin birth control pill. This was mainly for hormone purposes and keeping my cycle regular. It was very stressful as I had to constantly remember to take the Pill and when I missed then having the fear I would get pregnant. I don’t use contraception any longer as I had my “tubes tied” after having my children. The “tying of the tubes” is empowering as I no longer have to worry about any of the pregnancy scares, although I still need to use the Pill to regulate my cycle. That sucks, but no more worries if I miss one or two! --Esmeralda, 36
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"I feel empowered to know that the Pill allows me yet another way to be in control of MY body."
Damon Dahlen/Huffington Post
I was 15 years old when I first started using contraception. My nurse practitioner Connie back in South Carolina read this study that concluded that the Pill might help to rid me of my migraines, and it worked. Birth control literally saved my life! Once I became sexually active, my mother and I decided together that it was in my best interest to continue with the Pill. Between homework and an active social life, it was pretty hard to remember to take it each day. But not getting another migraine was my motivation. Today, I'm still on the Pill and I also use condoms. I feel empowered to know that the Pill allows me yet another way to be in control of MY body. --Dana, 30
"I now realize what a luxury it is to really have been able to plan my family the way that it worked for us."
Damon Dahlen/Huffington Post
I started on the Pill, Ortho Tri-Cyclen, when I was 15 due to horrible menstrual cramps. My mom was understanding and helped me get the Pill when I was a teenager, and I was able to continue getting the Pill via doctors and Planned Parenthood. I took Ortho for years until my husband and I started trying to conceive, when I was 27. Between babies we took our chances and after my son was born, I got a Mirena IUD. My periods after two children were horrendously heavy and lasted for days. My clothes were ruined and it was just exhausting. With the Mirena, I have no cramps and can barely tell I have a period. It's been wonderful. I now realize what a luxury it is to really have been able to plan my family the way that it worked for us. --Christina, 37
"I started the birth control pill to improve quality of life, not to prevent pregnancy. Ten years later, I take the pill to prevent pregnancy and have to carefully manage side effects that can affect quality of life."
Damon Dahlen/Huffington Post
I started the birth control pill when I was 16. At the time, I was put on Yaz to mitigate symptoms of PCOS. I had no problems with Yaz, I loved it. But it carried a higher risk of blood clots and by my mid-20s, I was constantly worried -- convinced every ache or pain was a sign of a life-threatening blood clot. The anxiety wasn't worth it, and my doctor also suspected I no longer had the hormone imbalance caused by PCOS that required a pill with more estrogen anyway. I switched to a pill with a lower dose of hormones about a year ago. There was definitely an adjustment period. I had some mood swings and weight fluctuations for about six months. Even after switching to a pill with less hormones, I started having extreme anxiety at around the same time every month. Recently, I discovered that's caused in part by a gene mutation that makes it harder for my body to remove estrogen and other excess hormones. That I take a birth control pill with estrogen every day probably doesn't help. I take special vitamins to prevent the buildup of hormones and other symptoms of anxiety caused by the gene issue. I also take baby aspirin when I travel to reduce the risk of blood clots. I started the birth control pill to improve quality of life, not to prevent pregnancy. Ten years later, I take the Pill to prevent pregnancy and have to carefully manage side effects that can affect quality of life. I'm considering switching to an IUD with less hormones. I'm very lucky, and feel very empowered, to have access to information to help make that choice and safe spaces to discuss it. --Amanda, 26
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"I am not currently using any kind of contraception, because I am trying to conceive."
Damon Dahlen/Huffington Post
I started using contraception (condoms) at age 18. I have switched only once in my life, to birth control pills to regulate my menstrual cycle. Once my menstrual cycle was regulated I returned to condoms. I have felt stressed in the past when I used condoms because I was fearful that the condom would break while having intercourse -- and it takes away from the passion having to stop those 10-30 seconds to put it on. I am not currently using any kind of contraception, because I am trying to conceive. Even though I am 41 years old, I hope to become a mother for the second time. --Cathy, 41
"For the first few years I was on the pill, it was only nominally contraception -- I wasn't having sex."
Damon Dahlen/Huffington Post
I first went on the birth control pill when I was around 20. I spent the day at my college infirmary because I was in so much pain from the cramps that none of my painkillers were helping and I spent hours incapacitated and sweating from the pain. My dad agreed that I'd use the Pill, as the doctor recommended, to control it. For the first few years I was on the Pill, it was only nominally contraception -- I wasn't having sex. My insurance for a while was through my dad's employer, a Catholic entity, so I had to have notes from the doctor saying it was for menstrual issues. Once I got on my own insurance and the new legislation cut the costs of my refills to nothing, it was pretty great. After a couple years I went on the generic of Seasonique because my monthly periods were still extremely painful, and it's been a lot better. When I got into a serious relationship, I was already set with birth control. At first I was constantly terrified that I'd be pregnant without knowing it for months before my four-times-a-year cycle came around. Plus I'm not great at schedules, so I don't always remember to take it at the same time, which freaks me out. I've thought about trying an IUD but I've heard it can be risky to use menstrual cups with IUDs, and I'm not giving up my DivaCup! --Claire, 27
"The pills help me enjoy sex without thinking about the repercussions."
Damon Dahlen/Huffington Post
I started using contraception my sophomore year of college when I became sexually active. I solely used condoms until 2014. I’m on low-dosage [of estrogen] birth control pills now. The condoms were fine but I wanted to make sure I was doing everything I could to prevent pregnancy. Now that I'm in a long-term monogamous relationship, I'm prefer using only oral contraception. I asked my friends a ton of questions about the birth control pills they were using before asking my gynecologist about my options. I was mostly concerned with major mood swings. Two of my girl friends recommended Lo Loestrin, which I've been using for over a year now. Remembering to take the pills at the same time every day is the biggest hassle for me. I'm grateful that I have insurance that covers the pills and that calling for refills is pretty effortless. The pills help me enjoy sex without thinking about the repercussions. It's also given me more control of my period which I love. --Joann, 27
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Editor's Notes: (1) The IUD used in the photographs is a demo ParaGard copper IUD provided by Planned Parenthood. (2) For logistical reasons, one of the photographs was shot in the Huffington Post office instead of the woman's bedroom.
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