Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Progestin only methods

2 January, 2005
Question:

Amongst the Depo-Provera shot, mini-pill and Mirena IUD (i.e., progestin only methods) which in your experience causes less staining problems in both the short and long term? Other than the diaphragm, are there any other non-estrogen methods that are potentially less problematic?

Thanks again for the wonderful service. Tizku l'mitzvot!


Answer:

All methods have different effects on different women.  Until one tries, one does not know how a particular woman will react.  The Depo Provera shot is least advisable, because it can't be removed or stopped.  If a woman has bleeding, she is stuck with the effects for months.  On Mirena, some women have no period and some have constant bleeding.  Also, it can be quite expensive if one needs to remove an IUD.  The mini-pill is the best way to observe how the body adapts to progestin only, without making a long term commitment.  If there is a problem, one can simply stop taking it. 

However, a woman must remember to take the pill regularly.  When beginning any hormonal method, one should be prepared give it at least two months' trial because many women with problems at the beginning improve over time.

The regular IUD (without hormones) may be preferable halachically to the diaphragm (although many authorities permit the diaphragm) but it can also cause spotting.  Spermicide is halachically acceptable, but is least effective at preventing conception.

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