We appreciate the sensitive nature of this question.
We’re sorry to hear about the side effects you’ve experienced with the pill.
Professional treatment can be very effective for dyspareunia ;and overactive pelvic floor. If you haven’t yet, we recommend consulting your physician and a urogynecological physiotherapist.
Unfortunately, negative side-effects from hormonal contraception such as you describe are fairly common. It definitely makes sense to find a birth control option that will better suit your needs.
If you would like to use FAM, we highly recommend learning it under the guidance of a certified teacher. Although FAM can be highly effective, its efficacy rates are much higher with proper training. If you write back with your location, we can help try to find you a teacher.
We understand why using a condom ;in conjunction with FAM seems like a good option. However, condoms are only halachically permitted in extremely extenuating circumstances (such as when one spouse is HIV positive). For halachically observant couples using FAM, a diaphragm with spermicide often works well as a back-up method. When fitted properly and used correctly and consistently, the efficacy rate of the diaphragm with spermicide is comparable to that of condoms.
Your conditions might complicate use of a diaphragm. Having it fitted properly, being trained in how to use it, and using a spermicide with some lubricant properties might ease those complications.
Another possibility is a copper IUD. This method has extremely high efficacy rates and does not involve synthetic hormones. While it is usually recommended for women who are looking for birth control for longer than six months, it is an option to consider and discuss with your doctor. If necessary, the IUD can be inserted with anesthesia, so as not to aggravate other conditions.
We hope this helps. Please write back with any further questions. Refuah sheleimah!
This response was updated on 14 November, 2022.