Trans man on testosterone needing help deciding on a secondary BC method

[0h60dd4mni7.livejournal.com]

Hey everyone!

I’m a trans man who takes testosterone, but often go without it due to money issues and needle anxiety. I’ve currently been off it for 3-4 months but plan on starting up again very soon.

I’m in a monogamous relationship with a non-trans man, coming up on our one-year anniversary. We have sex pretty often (at least several times a week, sometimes more than once in a day) and it’s always PIV. Sometimes we start out condom-less and put one on once things move past a certain point, and sometimes he puts a condom on right from the start. He knows his body very well and we’ve never had any close calls.


I DO NOT, under ANY circumstances, want to get pregnant. Lately I’ve found myself thinking, hours after sex, when he’s not around “You’re playing Russian Roulette, and if you get shot, it’s your fault.” Which is a terrible thing to think about sex, especially awesome, loving, safe sex with one’s committed partner. So I’m looking for a second BC method to mitigate that anxiety.

Currently I’ve narrowed down to Implanon and Mirena. My main concerns are:
a) Making sure the method doesn’t decrease the effectiveness of the testosterone, once I start it again
b) Cost (I’m a student with little to no income. I have insurance through my mom's work but I think I’m going to have to call and see what they cover, and my phone anxiety makes that an unfun prospect)

So do y’all have any thoughts on my specific situation, whether just advice about Implanon versus Mirena, other methods that might work better, or general advice that came to mind when reading this? I’ve done a lot of research, but I feel like there’s probably things I’ve missed or just haven’t thought about, and so I wanted to ask this community to weigh in. The only methods I’ve ever used are condoms and spermicide, so venturing into dealing with other methods is a little overwhelming.

Thanks in advance!

Comments

[kaberett.livejournal.com]

I'm trans and react really badly to progesterone. The Mirena contributed significantly to my depression, but I appear to be hyper-sensitive to the damn stuff. I also found that when I *did* have periods they were about eleven billionty times more unpleasant (like, not-able-to-call-for-help levels of pain), but I have endometriosis so that's probably less relevant to you!

Without knowing more about how you react to progestins, I'd be wary, honestly. If you know from past experience that they're not a problem for you, then GO FOR IT.

(I will also say that when I had my Mirena out early, it took about 3 days for me to get back to normal mood-wise. That's much better than typical for Implanon!)

[0h60dd4mni7.livejournal.com]

Hmmm. Oh man. This is definitely food for thought. I'm just so worried about getting something with progesterone and then finding out I react badly to it. Because if it were pills, I could just stop taking them and not buy anymore. But I don't think they let you return IUDs for a full refund, lol. Maybe a copper one, then.

[kaberett.livejournal.com]

A though I am not well/awake enough to articulate helpfully: you might be able to find pills that contain hormones equivalent to those in the Mirena and Implanon. You could then trial using the hormones orally, and if you get on with them move to a lower systemic dose.

[knittinggoddess.livejournal.com]

The Mirena contains levonorgestrol (spelling!), and PoPs in the USA don't. But maybe your doc can be open to ordering from Canada or somewhere else that has LNG POPs?

[somniumdraconae.livejournal.com]

It looks like USA PoPs are all made with norethindrone / norethisterone. It is actually quite similar chemically to levonorgestrel. So, if you wanted to have a go with norethindrone, it would be a good indicator to see how you'd do on levonorgestrel. Not perfect though, you can do good on one and terrible on the other. So if your doc is willing to help you get the UK brand Norgeston or the Aus. brand Microlut that would be better.

[somniumdraconae.livejournal.com]

You could always do a month of PoPs as an experiment. Every progesterone is a little different, so it wouldn't be a guarantee that you'd do well on a Mirena, but it'd be a good indicator.