We've been together for 5 years (going on 6) and we've used the pill (in various kinds and doses) for most of that time. Unfortunately, the pill has always been inconvenient for me (I forget to take it a lot), and the side effects have gotten to be too much. After the latest change in pills, I've completely lost my sex drive as well as being fatigued and I've been spotting every time I forget even one pill, and keep bleeding for up to a week after I remember to take them again. It's driving me nuts, and I've stopped taking them. Now I've been researching other birth control methods, only to meet with frustration - There is simply nothing out there that sounds like it would work well for me!
I tried the shot once, but the side effects for me were too uncomfortable and I decided not to continue with it despite reassurances that the nausea, spot bleeding, etc would go away "after a few more shots". I have a life to live; I can't be going about my job (which involves working in other peoples' houses, with kids) while wondering whether or not I'm going to randomly bleed through my jeans. IUDs carry too many risks, one-use contraceptives like diaphragms, condoms and sponges are inconvenient and unlikely to get much use especially considering most of our "alone time" is when one or both of us is already tired and doesn't want to deal with contraceptives. He doesn't want to deal with a vasectomy (although we have discussed it). I'm out of options, and frustrated.
Other methods of hormonal birth control like NuvaRing sounded good at first but now I am just sick and tired of hormones, and wary of trying any single-dose products after my experience with the Depo shot. I'm tiny (110lbs soaking wet), I have a very fast metabolism, and most of the hormone doses out there do not play nice with my body. I've had bad cramping, morning sickness, complete lack of sexual urges, yeast infections, and all kinds of other problems since starting the pill, and have changed it at least 3 times now due to supply issues (I get them through low-income clinics, so they don't always have the brand-name pills), complaints (I started on a higher dose pill, then was switched when I complained of side effects...), and finally because I moved to a new city and therefore a new clinic. I don't want to go back to the clinic and be told that they're switching me again, wait 2-3 months to see if my body adjusts differently to this pill, rinse, repeat. It's not worth wasting my time. I'm covered by SelectPlan so the pill is free (for now), but I want birth control that works for me.
At this point we are both in our mid 20s and don't want kids. Fiance says 'never', I say 'maybe we'll do temp foster care when we're rich', but we've pretty well agreed that I'm not going to be giving birth. I've looked at tubal ligation - what do you guys think of it? I'm not sure I'd be able to afford it unless PA's SelectPlan covers at least partial cost, but I'm going to talk to my doctor the next time I'm there, which might be a month or more... in the meantime, I wanted the opinions of real people, not doctors. What do you use as birth control? Do you think sterilization is a good option for me? If no, why not and what else would you suggest? And finally - do you know if PA's SelectPlan covers sterilization procedures and if not, how much I can expect to pay? We're relatively poor but I'm determined to get proper birth control methods in place before I end up paying for an abortion, and if I have to start saving for surgery, so be it.
When did you get your IUD put in place, and have you had any problems or changes associated with it? 

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