Devices.
Writing a post on the intrauterine device (IUD) that I acquired about three years ago has been on my mind for some time, but I had been on the fence about it because I thought that some of the details necessary to properly describe my experience might be TMI or squicky to some people. After having been asked about it by more than a few women who found out that I had one, and after thinking a lot recently about birth control and hormones, I decided that I would go ahead with the post, reasoning that it might help some women to have the information, and anyone who does not want to read further about the most delicate inner workings of my most delicate inner parts can stop reading right about…here.
I got a copper IUD (the non-hormonal type) inserted in September or October of 2008, after having been on birth control pills for twelve years, and having recently married. I made the decision to switch to a non-hormonal method of birth control because I was curious about what my womanly body would feel like in its natural state (I had been experiencing some sex drive problems, and looking for something to blame), plus I was honestly tired of taking a little pill once a day for forever, and I had borderline high blood pressure (which can be caused by BCP). Before choosing the IUD, I considered getting fitted for a diaphragm, and also considered using a computerized fertility monitoring device and just avoiding having sex during fertile times. I decided against the diaphragm because it is supposed to be used with spermicide, and I don’t care for the stuff; I decided against the fertility-avoidance method because what I last remembered of my natural cycles was that they were horribly erratic, and there seemed to be too great a chance of messing it up. I hadn’t originally even considered an IUD at first, for two reasons:
1) I’d heard horror stories, both about failure (someone I knew said their mom got pregnant even with an IUD in place) and about damage to the organs causing infertility,
and
2) I was under the impression that they wouldn’t even “install” an IUD in women who had never been pregnant, and I never had.
Then I heard that someone I knew had (and liked) their copper IUD, so I did some internet research which quickly cleared up my misgivings on the first point: the older IUDs had some serious issues, but the newer ones were both safer and nearly as effective (99.4%) as perfectly-taken birth control pills (99.9%). And really, who has taken their birth control pills 100% perfectly, at the same time every day, without ever forgetting one?
The second point was a little hairier. After calling around, I reached a few doctors who were completely unwilling to insert an IUD for a woman who has never been pregnant, and went to a consultation with one doctor who would only prescribe the Mirena (hormonal) IUD in such cases. Finally, I found a woman doctor (not sure if this had anything to do with it, but all of the no-gos had been men) who was both on my insurance plan, and willing to do the insertion.
Luckily for me, my then-husband had really good insurance, so the whole thing cost me only a $15 co-pay. The husband part was actually kind of important, too, because even the willing doctor I found was explicit about the fact that my being married played a large part in her decision to insert for me, since IUDs are recommended for monogamous relationships where the risk of STDs is low. At the time, I was living in North Carolina…your experience, in more liberal or more conservative areas, might be different.
I don’t remember much about the individual steps of the procedure, only that it hurt like the dickens. But only for a brief moment; it was more intense, but much shorter in duration, than getting a small tattoo. Immediately after the procedure, I had some very serious cramping for a bit, bad enough that it made me run to the hallway bathroom to take an emergency shit on my way out of the building. The mega-bad cramps subsided within an hour, and I had some moderate cramping for the rest of the evening. The next day, I was fine.
A few weeks later, while doing the recommended string-check to make sure it hadn’t expelled, I felt the end of the device protruding from my cervix. That was not supposed to happen. I had to go back to the doctor’s office and get it adjusted. This is apparently rare. The doctor who fixed it was the resident expert on insertion, and explained to me that the first doctor was not very experienced in that procedure. I wish he would have been the one to do the original insertion, but hey, you take what you can get. The adjustment, once again, hurt like the dickens, but I have not had any problems since, and there was no additional cramping after the adjustment. I would recommend to anyone considering this route to make sure their doctor is very experienced.
For the first couple of months of having the IUD, I had some interesting side effects. One was copious amounts of cervical mucous that felt like gobs of snot falling out of my vagina from time to time. Another was an extraordinarily painful and heavy first period. Over time, the pain of my periods and the heaviness has decreased, to the point where I now have what I think is a pretty normal period, lasting from 5-7 days. Some months, I do still have intense cramping, but it only lasts for a day or so, and is killed with large doses of Aleve at regular intervals. But for the first year, the cramping was so bad for about 1-3 days, that no amount of NSAIDs could help me, and those days I was useless for anything other than lying in bed with a heating pad pressed to my abdomen. And the bleeding was so heavy that it made me anemic and I had to use an iron supplement that tortured my stomach.
I don’t want to scare you away from getting an IUD…now, I actually LOVE mine, and later on I’ll detail exactly why, but I want to honestly present the side effects that I experienced, and in that first year, not all of them were pretty.
A little tangent on my personal history, and the facts about birth control pills:
I first got on BCP when I was 14, about a year after becoming sexually active. I got them free from a clinic near where I lived in Baltimore, and I took them religiously. My mother had made it clear that I “was not aborting any grandchild” of hers, and pointed me in the direction of the same place she used to get hers back in the day. I started menstruating at 10, and my periods were never anything that approached “regular” until I got on the Pill; I’d go for three months without having one. My cramps were super intense and evil in those early years, to the point where sometimes I’d just lie on the bottom of the bathtub with the shower running and moan.
When I got on the Pill, not only did I get to have predictable periods, but they were lighter and shorter. AND of course, I didn’t have to worry about pregnancy. For a brief time while I was 19 and single, I went off the Pill. I didn’t get my period at all for three months, and went to the doctor and, for my irregular cycle they prescribed me…the Pill again. So that’s how I ended up having been on birth control pills for over 12 years by the time I turned 27.
So my really bad first year with the IUD may have been just a continuation of that rather than an effect of the device itself. Lighter, shorter periods are a known, common side effect of hormonal birth control, so part of my trouble was probably adjusting to my natural state.
Anyway, back to the original discussion…
After having been off the Pill and with the IUD now for three years, I can pinpoint a few other effects of being hormone-free:
1) My sex drive. It was definitely affected by going off the Pill. For the first almost-two years of being off of it, I was a ravenous, sexually-insatiable beast. I wanted sex ALL THE TIME. Even my desire for girl-loving skyrocketed. Sex became more than a nebulous idea floating around in the back of my mind that I could concentrate on and will myself into wanting, which is what it had been for years. It became a primal, visceral NEED. In the past year, it has mellowed a bit, but definitely spikes around ovulation, about which I will say more later.
2) Attraction. Speaking of sex, I believe that my relationship with my husband began to deteriorate for reasons other than only how he treated me (although that was the vast majority of it). According to fairly recent studies, birth control pills interfere with the natural mate-selection process. Women on the Pill choose, based on pheromones, different mates than they would choose in their natural states.
Once I reverted to my natural state, I found myself being nearly irresistibly attracted to all sorts of men…men who weren’t my husband. I would get weak-kneed over random dudes who sat next to me on the university shuttle bus. Develop crushes on classmates at school. Engage in risqué banter with coworkers I’d known for years but never found attractive before. The foundations of my marriage were already weak, and I believe that this new level of attraction that I had not ever experienced while artificially estrogenated (new word?) gave me a glimmer of hope that there was more out there for me. I think it pushed me a little further toward moving on.
3) Hair. When I hit puberty, I sprouted quite a bit of body hair for a teenage girl, including a rather pronounced “happy trail”. I believe that my arms were also hairier than normal. By the time I was 13, I inhabited more-or-less the same size and shape body that I have now, with slightly slimmer hips…and more body hair. My hair also had a bit (not much at all, but a bit) of a wave, especially in the coarser hair on the underneath toward the back of my head.
As I grew older, my body hair grew thinner and finer, and my head hair got finer and straighter, to the point where it was stick-straight. I had just attributed the body hair decrease to the effects of plucking and waxing…by the time I was 23 or 24, I never had to wax anymore. But then, after I went off of the BCP, slowly, very slowly, it started to grow back. Now, I am back to the same level of plucking and waxing that I needed at 18; I also am growing my hair long for the first time in a few years, and lo and behold, the itty-bitty amount of pre-Pill wave is back. To the wave, at least, I say, “HOORAY!”
4) Zits. I never was a pimply person, but now, I get a zit or two about once a month.
5) Natural cycles. For the first time in my life, I have a naturally regular menstrual cycle. It comes complete with the previously-mentioned libido spike around ovulation, cramps that start about a week before my period does, two or so days of wicked irritability, and a general predictability (though I don’t think I’ll ever be a to-the-hour kind of girl). If I woke up from a coma and had no idea how much time had elapsed, I could almost tell what part of “my” month it was just by my mood, libido, energy level, etc. I think that’s kinda neat.
…
So, I’ve discussed some of the drawbacks and the neutral side effects related to the IUD and going artificial-hormone-free. Now for the good parts:
1) The sucker is good for TEN. FRICKING. YEARS. While there is a good chance that I will want to have it out in order to breed at some point before its 2018 expiration date, even if that happens, I can get another one, and it’ll be good for ANOTHER TEN YEARS. Which basically means that, as opposed to having to take a pill every day, or apply a patch every week, or insert a ring every month, and all of the related doctor visits for prescriptions, I have to worry about getting new birth control only twice before I’ll be biologically incapable of conceiving and never have to worry about it again.
2) Spontaneity. I am not just talking about in-the-heat-of-the-moment here, like one must deal with for the barrier methods. (And of course, condoms are still advisable in situations that aren’t long-term monogamous or polyfidelitous). I’m also talking about being able to leave on vacation, or crash at someone’s house for a couple of days in a row, without worrying about whether you have your pills (or whatever) with you, or whether leaving them in a certain place will expose them to too much heat and make them ineffective, or if you need to stop at the pharmacy again. Truly, it is freeing.
3) Certainty. With a birth control method so foolproof, there is very, very little chance of unplanned pregnancy. And even if I ended up being one of the 6-in-1000 women who do manage to get knocked up even with the IUD, the IUD is so bad for pregnancy that I would be far less conflicted or guilty feeling if I decided to abort.
4) Reversibility. If I do decide I want to conceive a child at some point, I just get the thing yanked out, and there is no amount of time I need to wait for my body to adjust…I’ve already made the journey from hormonally-doctored to all-natural. It took about two years for my body to completely adjust and get regular, predictable cycles where I can actually feel the ovulation taking place. If I were on hormonal BC and decided I wanted a child, that means I probably would have to have waited around two years to be able to conceive…kind of a big deal seeing as how if I ever do have a kid, I plan to wait to near the last feasible minute.
5) Certainty (for him). My boyfriend never has to doubt my birth-control status, because he has access to my vagina and could just stick a finger in there and feel the damn string for himself, if he were doubtful or curious. I have not asked him if he has ever (purposely) done this, but I would not fault him for it of he did or had, since it is not unheard of for baby-crazy ladies to be less than honest and/or vigilant in their BC practices.
6) Health issues. I no longer have high blood pressure. If something goes wonky in my body, I know it’s not a side effect of my hormonal birth control. If I have a weird cycle after months and months of normal ones, I will go to get it checked out, because my cycle is my own natural cycle and not just withdrawal bleeding.
I guess that about exhausts all I have to say on the matter. I edit my posts a lot, so if I think of something important that I forgot, I will come back and add it in. Sorry if any of this was too graphic, but I did warn you.
