Follow me on the crazy, hopeful, discouraging, funny, and ultimately successful (one way or another) path to parenthood while facing infertility.

Wednesday, July 13, 2016

Birth Control Irony

It is so frustrating to me that there are not better birth control options for women. That in a time of amazing advances in so many areas, there aren't huge advances in birth control options without side effects or unpleasantry.

After we decided to end treatment, I went off birth control completely. It was freeing. I wanted to see what my body would do, unfettered by all the drugs and hormones I'd been pumping through it. I also was kind of daring it to be normal for a change. Just figure this shit out, I whispered to my lady parts. 

It worked great for the first month and change, with me getting a period in a somewhat timely fashion and then having that period end neatly, no weird spotting. But then things got icky. I went longer, then started spotting, then the spotting never really became a period, except maybe for a day or two, but it was completely unpredictable. I started wondering if I could be pregnant. I started worrying that by not being on birth control I'd opened myself up for a "miracle" pregnancy gone horribly wrong... one that would end in miscarriage, or another ectopic, or maybe a touch of fetal alcohol syndrome from Friday night margaritas and pairing a nice bottle of wine with our dinners. 

I decided I needed to be on birth control, in part for my own sanity and also to try to make the spotting ridiculousness go away. Yes, I know that this means that a spontaneous pregnancy would be totally off the table. But honestly, isn't it ALREADY off the table? I am good with hammering that nail in so hard it can't be undone so that I don't have to live with yet another kind of uncertainty.

I found my choices incredibly limited. I couldn't be on anything with estrogen in it, because my OB/GYN wasn't comfortable with my migraines and prothrombin gene mutation. Which left me with IUD (no thank you), implants (um, no), progesterone-only pill, or Depo Provera. 

So I tried the progesterone-only pill. Which was great, at first. 

After the second cycle with it, I started spotting. Like all the time. As in, living with a light period every single day. I know I don't want to wonder if I'm pregnant, but I also don't want to own stock in sanitary products, either. And by sanitary products I mean superthin pads, because I am still trying to get over the whole idea that tampons are horrible for you. Someone told me once, or I read in an article somewhere, or it just planted itself in my subconscious during my ultimate crazy fertility time, that tampons actively change the pH of your vagina. That they can disrupt your natural state of being and hamper fertility. Plus, it's a foreign object in your body, which is not my favorite thing, but life was so much easier when I just used tampons. I have to say, though, that the new superthin foam shark-gill-looking pads from Al.ways are amazing. And the same company makes ultrathin pantyliners that are surprisingly effective even if you go from spotting to light flow, and they have saved my pretty underwear. Aren't you so glad I'm sharing all this? I would love it, actually, if people were far more comfortable talking about periods and stuff. But that's a topic for a different post.

I decided the progesterone-only pill was a disaster and left me feeling like I was 13 again, not sure when I might start bleeding or how heavily, and so I went to my OB/GYN begging for a different solution.

If I don't want to do anything invasive, like the IUD or the arm implants (which creep me out immensely), and I don't want to do anything surgical and totally permanent, like ablation, then my ONLY option left was Depo Provera.

Which is highly ironic.

That's because it's an intramuscular shot into the behind, much like the PIO I suffered through for YEARS that has left giant knots of scar tissue and lumps in my rear, something that comes up anytime the massage therapist I see does glute work like, "What did you DO to your ASS?"

It's basically long-acting progesterone, not necessarily in oil (I don't know what it's suspended in, but it's probably oil), shot every three months into my behind.

Only this time, a nurse does it. They're so cute, too, because they mark which side they do in my chart so they can alternate. And I'm like, "Does it really matter? I did this TWICE A DAY for one protocol, and that's when alternating matters. I can't even feel where it went three months ago." We used to track it ourselves, but instead of "left" and "right" we did "dragon side" and "non-dragon side" because I have a rather large dragon tattoo from spine to right hip. I don't think they chart it that way, but I think at least I make it an interesting view. I know exactly how to stand, all my weight on the opposite leg and relax my muscles as much as possible so it goes smoothly into the muscle. I know what it will feel like an hour later, when it's super sore and knotted. I am tempted to bring a hot pad with me. Sometimes I do heat my butt when I get home, because that was a great tip for PIO shots, and it still works for this.

This time, though, the shot in my ass is to PREVENT a pregnancy, not sustain one.

Although in my case, it's not as much to prevent as to maintain my sanity and help me have periods that are somewhat normal.

Or, as it turns out, no period.

I thought it would be weird to be on a birth control that gets rid of your period. I worry about the side effects of that, of whether it opens me up to yet more reproductive cancers, or if it's just fine. If my doctor says it's fine, I'm just going to go with it for now.

Because I've been doing it for 9 months now, and I have to say that I LOVE Depo.

The first couple shots were rough. I would be spotting-free for 6 weeks, and then bleed THE ENTIRE REST OF THE SIX WEEKS. Which is not so lovely. I also had an uptick in my migraines for the first six months or so, because it can exacerbate those. But, I was told to give it time...that most people try Depo and drop it after 6 months because of these things but if you give it a year you will see a major improvement. You just have to be okay with constant spotting for a finite amount of time.

Well. I'm about to get my fourth shot in a week or so, and I can say that this last 3 month period involved very little spotting, and very few migraines. I am a convert. I am even less cranky (although maybe you should ask Bryce his opinion on that one). Because in the beginning, holy hell was I CRANKY. But that, along with the weeks of bleeding and headaches, has abated as well.

I'm so glad that this is working out. I really didn't relish the idea of burning off my endometrial lining surgically, especially since apparently you can do that and have it not work 100%, and it's best to do that closer to menopause. Also, my doctor threw out the idea of hysterectomy, which was INSANE to me because, um, can we explore other options before REMOVING ONE OF MY ORGANS? No. Not happening. Only if medically necessary, and I don't think spotting qualifies.

I am happy to not get a period every month, too. Even though it's been years, and even though I know there's no chance, I just still feel it is so unnecessary to have to bleed when you are hideously infertile. I thought as a teenager how lovely it would be to have a little button in your back, and you could turn on periods when you truly need them for reproducing, and turn them off when you don't. I am super excited for menopause, because I want this sham of reproductivity to be over, for real. Unfortunately, I don't have a family history of early menopause. I have this terrible feeling that my body is going to hold out just to spite me, and I'll be having periods when I'm 60. (Or not, because of the Depo, but of course you can't stay on it forever because of the risk of "brittle bones," which is kind of horrifying too.)

I implore science to come up with some new options. Ones that don't come with horrible side effects or removing body parts. In the meantime, I'm perfectly okay with my highly ironic, quarterly progesterone butt shot. I'm a pro at that sort of thing. 

18 comments:

  1. I wanted that same button! I hope the Depo continues to work well for you. When the time comes, maybe consider investigating a Lily Cup (https://www.intimina.com/en/lily_cups). I used something similar years ago, and it was a pretty decent alternative to tampons. I only stopped because when it came time to replace it, I was convinced my period was about to go away. And it did, six years and a surgery later. *grin*

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    1. It would be a great button, right? The Depo seems to be doing what it needs to do, and better each 3-month cycle. I haven't heard of the Lily Cup, just the Diva Cup, but I will look into it! With the Depo I don't think I need it, finally. Just pantiliners just in case. :)

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  2. Yeah, women's health. We are severely behind with our understanding of this, which is utterly insane given that this impacts 1/2 our population directly and everyone else indirectly. Still, we are a world that gets squimish about menstrual cycles (boons too for that matter) and there's still this assumption that because people aren't going to immediately die that it's somehow less important. So yes, we need to do better.

    I have an IUD because I was (and still am) done with manipulating my hormones. I don't think we know enough about them and the long-term effects. IVF also gave me a crash course in the effects of manipulation, so the IUD made sense to me. But I am curious about your experience with Depro.

    I also started using a menstrual cup after the Beats were born and it truly is an amazing device. Highly recommend if you are looking for an alternative to tampons and pads.

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    1. I hear you on the hormone manipulation. I just didn't want something invasive in my body, but I guess I have hormones invading my body that aren't supposed to be there, so six of one, half dozen of the other I suppose... I wish there was a better way. I do enjoy the Depo though, now that the adjustment period seems to be ending. I will have to look into this menstrual cup! It always seemed rather unwieldy and with my luck I'd have a Carrie-like experience with spillage at school (that's not a custodian call I'd like to make). Of course Carrie further stigmatized periods, so there you go. ;) Thanks for your thoughts!

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  3. Glad that you were able to stick out the side effects and find something that worked! I had not realized that Depo is essentially a PIO shot (no fond memories of PIO here either - I still have 2 small numb spots, but your experience with PIO sounds really, really rough). Not so bad though every three months. Birth control is definitely a tricky business. Like you say, there really has to be a better way.

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    1. I do really love the Depo, and I'll have to ask today when I get a new one how similar it is to PIO. It's probably like Lupron vs Lupron Depot, more of a sustained release of the hormone than a one-shot deal. PIO and I were not friends by the end, and I suspect I will have lingering effects from the injection sites forever. Hopefully not, but man it did a number on me. SUCH a tricky business, birth control... and even just period management. They should come up with something specific to PCOS in my mind. Thanks for your thoughts!

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  4. I am glad the Depo works for you. I wish my daughter still had insurance. She LOVES Depro.
    Yes!! WE should be talking about this more. And please may more / better options become available.

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    1. Yes... Depo! The injection solution itself falls under the new healthcare free birth control, so that is no charge... but they do charge a copay for the injection itself. I don't know what that would be without insurance. But the Depo itself should be free! I asked if I could administer myself at home since I (Bryce, really) have a lot of experience with it, but they said they couldn't do that because if I got pregnant (ha ha ha) they'd be liable for letting me do it in a non-controlled environment, not being a health professional myself. Oh well. I tried.

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  5. I have followed many of your blog posts, as I can identify with a lot of what you talk about. Also, I'm a teacher (& from the Syracuse area originally) and understand what it's like to juggle RE appointments with a set, non flexible school schedule. In this post, I was surprised to see that you look forward to menopause and that you "unfortunately" don't have a history of it in your family. I was diagnosed with Primary Ovarian Insufficiency last year at 37 years old. My FSH was over 80 this past March when my husband and I decided to end fertility treatment and focus on adoption. I am in early menopause and have experienced hot flashes, mood swings and anxiety over the past year. I now have to be on HRT to balance my hormone levels. I don't wish this diagnose on anyone. Please be careful about wishing for menopause because the 1% of women who have POI, like me, have had to face a devastating reality.

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    1. I am sorry that you are suffering POI, and I certainly didn't intend to make light of a serious and devastating condition. To clarify, what I meant by early menopause was "earlier" '-- Not a medical condition that causes menopause on your thirties or earlier, but just an earlier onset within the normal window, like 46 instead of 56. I am tired of my body pretending it can function in this way when obviously it cannot, but I sincerely apologize that my flip comment about just wanting it to shut down my reproductive "capability" now that I have no use for it was insensitive to you and other POI sufferers. Please know I meant no harm.

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  6. I wish that there were other options as well. I was so excited to be off birth control before we started to get pregnant because although it was an amazing thing that kept me from getting pregnant for over 10+ years (although probably not considering we needed IVF), I was ready to be off hormones. Based on the fact that my body loves to create fibroids however, I will likely go back on bc after I am done nursing baby #2 which I'm not super excited about, but it seems as if it is a necessary evil.

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    1. It is a necessary evil... I am very envious of people who are regular without it. I'm sorry you have the fibroids... it is so frustrating when the body just doesn't comply. I would love to be free of hormones and messing with that area of my body, but unfortunately for me that results in about three periods per year that are humdingers and unpredictable and lead to horror show type situations. My adolescence is full of scarring stories like that... :) So Depo it is. I hope you can find an option that works great for you!

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  7. I had both of my fallopian tubes removed when I had an ectopic during a donor egg cycle. (I asked her to take both because the fear of another ectopic was overwhelming.) At that point I assumed we would eventually be successful with DE and it wouldn't ever matter, but then we stopped ttc and moved on to adoption. The first month was rough realizing I wouldn't be able to get that "miracle pregnancy" you hear stories about, but now I'm glad that getting pregnant is completely off the table. My heart and mind would never let it go, I would always be thinking every twinge was a possible pregnancy. I'm glad I made that decision last year and I can move forward with our next phase and not live in constant pregnancy watch. I hope Depo works well for you, brings you mental peace, and your baby comes to you very soon!

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    1. Oh, I relate to your feelings so much! There is definitely peace in knowing it's pretty much impossible to get pregnant. Interesting, I asked them to take both my tubes too when I lost my right one to an ectopic, and they wouldn't do it. I wish they had... :) While it stinks when hearing about these spontaneous pregnancies, I feel as you do, that the risk of going nuts every single cycle thinking maybe you could be pregnant is just too much. I wish you luck with your next phase and am glad your decision gave you peace, although I am sad for the circumstance that led to that decision. Thank you for your thoughts!

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  8. While I was reading about what you have been doing to medically to help manage your periods for your comfort and peace of mind, I got totally distracted. You have a tattoo?? I was somewhat surprised. But when I thought about it, a dragon kind of fits. As I kept reading I was thinking all of this rigmarole sucks, but...she has a dragon tattoo!! Sorry. But I'm glad that sticking through past the six month mark has worked well and that things are improving.

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    1. How funny! Yes! I have a big old black dragon on my back, that covers up another tattoo that was literally a monkey on my back. The dragon is WAY better as it is 100% me and my own power (I was born in the year of the dragon) but it ended up WAY bigger than I originally intended. It was freehanded with a sharpie by the artist, which is pretty cool (mostly because I freaked out when they said the dragon I picked wouldn't work for that purpose and I was like I AM NOT LEAVING UNTIL YOU COVER THAT DAMN MONKEY WITH A DRAGON! ANY DRAGON!) I also have a smaller one on my right inner ankle that's a snake, because I love snakes. I am thinking on another one now that I can because IVF is over (you can't during that process due to hepatitis risk, but I'm not going to someone's back shed or anything to get these...). Too funny. It IS a distracting fact... And yes, the whole rigamarole does suck. Having a dragon tattoo is a pretty neat hidden fact though. :)

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  9. I will talk periods and birth control with you any ol' time. I know IUDs freak people out, but I had one for 5 years when my pelvic floor muscles locked up on me and caused constant severe cramping (true story) and LOVED it. No period at all for 5 blissful years. Best skin of my life. If donor sperm ends up resulting in a take home baby, husband is going to get a vasectomy because if his genes were causing the miscarriages, an accidental pregnancy sounds absolutely horrifying. You're the first person I have heard understand why I do NOT want some "miracle" pregnancy.

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  10. Interesting. I'm glad you found an option that works! I have never been on BC other than for IVF (and didn't like it). I guess I'm lucky that I've never needed it due to lifestyle/infertility, but it's good to know there are options should I ever want for some reason (though hormone replacement therapy may be more likely in my case).

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