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.