Warning: This is completely based on my own experiences; please do your own research before trying different types of birth control.

TL;DR: Sex hormone binding globulin (SHBG), which is anti-correlated with free testosterone, seems to predict how well I tolerate birth control. None of them does everything I want--I just want to be me without the painful periods smh.

I started getting painful cramps in high school, but it was mostly manageable as long as I took some Tylenol within eight hours of my period starting. If I forgot, I was mostly fine, just in some pain. I would cramp for a few hours, and then it would subside. By the time I finished college, if I didn't take Tylenol[1] within that timeframe, I would be bent over in pain and nausea for a while, maybe half an hour, I don't remember anymore. It would drain me of all energy, and I'd be tired for another few hours. I almost always had irregular periods; I learned at the end of college that if I worked out 4 days a week, I could have a regular period that didn't hurt a ton.

Then grad school happened. The summer before was [...]

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Outline:

(01:37) Choosing a Progestin

(02:29) Annovera (Feb-April 2023)

(03:16) Yasmin (April 2023-Feb 2025)

(04:42) Nuvaring (March-May 2025)

(05:37) Natazia (May 2025-Present)

(07:05) Nextstellis (March 2026)

(07:57) Conclusion

The original text contained 1 footnote which was omitted from this narration.

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First published:
April 17th, 2026

Source:
https://www.lesswrong.com/posts/EfvePeHnW2EajwH8s/3-years-of-being-on-birth-control

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Narrated by TYPE III AUDIO.