How to Do It

My Wife Just Went Off Birth Control for the First Time, and Oh My God

It’s like she’s a different woman.

A startled man next to some birth control.
Photo illustration by Slate. Photo by Matthew Osborn/Unsplash.

How to Do It is Slate’s sex advice column. Have a question? Send it to Stoya and Rich here. It’s anonymous!

Dear How to Do It,

My wife and I have been together six years, married for three. In the beginning we had frequent, exciting sex but it dwindled, and we’d recently been talking about opening the marriage because my sex drive is higher than hers.

My wife had been having serious migraines and unexplained pain and nothing seemed to solve them, so two months ago her doctor took her off birth control in a Hail Mary attempt to get to the root of them. It worked, but it also did something else. It’s like I’m suddenly married to a different woman—she initiates sex, we have sex three to four times a week, she lost some weight that she always complained about, and she seems to have tons of energy.

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Mostly I’m thrilled both for her, and for the direction our sex life and relationship has taken. One problem though: birth control. She had a bad experience with the copper IUD early on, but hormones are obviously not the answer. The thing is, I hate condoms. Hate the way they feel like they’ll slip, hate the way they interrupt the moment, hate not being skin to skin. We eventually want kids, so she can’t get her tubes tied or vice versa, but it doesn’t seem like there’s a lot of other options here. How can we keep the new (old) sex life, but lose the condoms?

—Lucky and Unlucky

Dear Lucky,

I reached out to Mike Ripley, a friend of the column and an OBGYN at Dalhousie University in Canada. “I think the main thing to know here that is that the traditional birth control pill has two hormones in it, an estrogen and a progestin. And these two hormones are chemically very different and have different side effect profiles,” he clarified in response to your letter. From what you’ve said about your wife’s experience, this next part won’t surprise you: “Headaches are a known side effect of estrogen-containing contraceptives and are not recommended in patients who get migraine headaches with auras, so it makes sense that his wife’s migraines have improved since stopping her birth control pill.“

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But progestin-only pills, or other delivery methods, might be worth a try. “Progestins, on the other hand, don’t tend to cause headaches,” Ripley said. “There are a number of options for progestin-only contraception, with a number of routes of administration available that include a pill, an implant that can be placed under the skin which releases a progestin continuously, and a progestin-secreting IUD. Of these options, the progestin IUD is the most commonly used and is very effective for preventing pregnancy (in fact it’s more effective than the traditional birth control pill). Unlike the copper IUD that his wife previously used, these progestin IUDs tend to make periods lighter rather than heavier.”

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Progestin can still cause issues of its own, though: Ripley pointed to “irregular bleeding or spotting when starting their use, bloating, low mood especially in those who are at risk for depression or other mood disorders, and weight gain, although in most studies this weight gain has been minimal—usually less than 5 pounds.” He suggest your wife talk to her gynaecologist about this option.

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I understand traditional vasectomies aren’t guaranteed to be reversible, and you don’t want to go that route. As a show of good faith, though, you can also do some research into the various male birth control projects underway, and keep an eye out for FDA approval of one of those methods.

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Meanwhile, there’s a whole world of mutually pleasurable actions the two of you can engage in that don’t get semen anywhere near her cervix. You might focus more on the kinds of sex that are unlikely to lead to pregnancy while you sort this contraception issue out.

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Dear How to Do It, 

I’m a woman in my 20s and recently moved to a new city and into a house with several male roommates. One of the roommates and I have spent a lot of time over the past few months, and it’s been clear that there’s been a bit of sexual tension—we watch movies late at night together (and talk in the dark long after the movie is over), he once invited me into his room after one of these movies, and we’re generally fairly flirty. (Another roommate told me he could tell there was something going on.) I’ve been pretty into him and have wanted to hook up casually, but never made a move and he didn’t either. However, about a month ago, I worked up the courage to ask him what he thought our relationship was, to which he responded that he thought we should just be friends.

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I’ve since realized that my “move” was far too serious given what I actually wanted—not to date, but to hook up. He definitely thought he was choosing between dating and being friends, and that he hurt my feelings. (I was a little surprised but not hurt at all.) I haven’t seen him or talked to him outside a few texts since then, as we’ve both been travelling. He has also since quit his job and will be moving out of the city/our house in the next few months. Is it worthwhile to clarify what I was asking for? I’m not only concerned I’ve miscommunicated my intentions, but also that he may feel awkward around me now and that I’ve lost one of my few new friends.

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—Friend Without Benefits

Dear FWOB,

I think a second conversation to clear the air is worth the risk of upping the awkwardness between the two of you.

Send him a short text, letting him know that you think you’ve had a miscommunication and would like to clear the air whenever he has time. From there, it’s up to him to respond and make the talk happen or not. Think about what you’ll say beforehand. Maybe write it down, practice it out loud, or with a friend. The shorter and more direct you can be, the better. You also might think through the different ways this could go. If he wants to have a casual sexual relationship with you in the time before he leaves, would you still want that? Good luck.

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Dear How to Do It,

My husband is a morning person. I’m an afternoon person. Our schedules tend to mean that morning sex is the most convenient way to go, and we can get at it several times a week. The only slight problem is that I am sexually sluggish in the morning, and while I welcome and enjoy the interaction, I usually don’t reach orgasm. When we can get together in the afternoon, I tend to come very quickly and intensely.

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I love having our morning connections, but I’d love to train my body to react a bit more readily at that time of day. It would be nice for both of us! Any suggestions?

—Dawn

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Dear Dawn,

Do you use vibrators? If you don’t, are you open to them? Small lipstick vibrators can be good for inserting between your bodies during penetration. And the sonic ones that enclose the whole clitoral glans are manoeuvrable and majestic. If those aren’t strong enough, the also manoeuvrable Magic Wand is worth a shot. My thinking is that you might orgasm earlier in the day with more targeted clitoral stimulation.

I’m also wondering if this is a more holistic sleepiness, and if some part of your morning routine can be quickly done to get your body going. For me, it’s coffee. For you, it might be a brisk shower or quick exercise.

Dear How to Do It, 

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I have been married for almost three years to an overall kind of considerate man. We have fantastic sexual chemistry and typically have sex three times a week. This is the second marriage for both of us. His first marriage was sexless for many years. We are both in our early 50s.

For the past six weeks, I have been having awful neck and back pain. I have been to an orthopedist and I am doing physical therapy. I am slowly getting better, but it’s been difficult. I can only have sex comfortably if I lie on my back. I can’t get on top right now or do the normal things we used to do. It’s still enjoyable, but I am looking forward to getting back to my old self.

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The pain has taken a toll on me mentally, and I have been feeling depressed. My husband somehow has been luckily spared in life and he has never experienced depression. I have had several bouts of moderate to severe depression in my life.

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This weekend, I had difficulty just motivating myself to get off the couch. I didn’t eat very well, and I’m not sleeping well due to the pain. My daughter was out of the house for the afternoon and he wanted to have sex. It has been a week since the last time, and I think he gets antsy if we don’t have our normal routine. I told him I was feeling wiped out and not up to it. I have made it clear to him that I am depressed right now and I don’t feel well mentally or physically. I am going out of town In a couple of days for a week, so he said that we should have sex tomorrow night then.

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I don’t think he understands how depression makes a person feel-and I said this to him. I also think he thinks I can just turn a switch on and things will be back to normal and I’ll be raring to go. I felt guilty that I didn’t have sex with him this weekend and I feel it is my duty now have sex with him tonight no matter how I feel. I am sad and angry and hurt.

—Downtime

Dear Downtime, 

Your overall kind and considerate husband is being incredibly self-absorbed and unkind on this subject. I imagine his first marriage is affecting his response to your temporary sexual limitations, and making it difficult for him to empathize with you. On top of that, from what you say, it sounds like he doesn’t understand depression, or significant pain. He’s pressuring you into sex that you don’t feel like having. This is unfair to you, and an unacceptable situation. Your feelings of sadness, anger, and hurt are valid.

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You’ve made it clear to him that you’re depressed, and feeling poorly mentally and physically, but have you explained what that means? If he doesn’t have experience to draw from, he might not understand the ramifications of depression on your libido and energy levels. If you haven’t, it’s worth giving that a try. If you have, I’m not sure what else you can do to improve the situation yourself.

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Ideally you both start therapy individually and see a counsellor together. I don’t know if there’s a budget for that, whether you’re open to it, and whether he’s open to it, but if it’s possible, I think it’ll help a lot. Your husband sounds like he’s unable to understand you, you sound like you could use someone to talk to about a lot of this—including your depression, yes, and also your long-term pain—and the two of you could use some help communicating. It’s also worth thinking about how much you’re willing to tolerate in a relationship, and what the point of no return is for you.

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