I have a decision to make. It’s a decision that most women have to make. It’s a decision I’ve made many times before, without actually knowing what I was deciding. It’s a decision about birth control.
Most women (I have no idea the statistics on this one, but I’m assuming that it is most), at some point in their lives, have to think at least a little about birth control. I’ve had to think about it a lot in the last 2 years, probably way more than “most” women do. I have no answers here, just tons of questions. So this is my journey.
I started taking birth control pills when I was 16. I don’t remember the specifics on why, but I do know I wasn’t a virgin at that point. I don’t remember what type I took, although I assume it was a combo-pill. I do know that I didn’t think about anything, nor was I “taught” anything. My mom took me to the doctor. I got a prescription. I had to take the pills so I wouldn’t get pregnant. End of story.
Up to that point, my cycles were regular, easy, uneventful. I didn’t have all the symptoms my friends did. My period was just a monthly annoyance that came and went on time. Nothing changed after I started taking the pill, except 1) I had to remember to take it, and 2) I could see exactly when my period would start. Everything was sooo regular.
Fast forward 8 years, and I was newly married, in the military, and deployed to the Arabian desert. My then (new) husband and I wanted a family, and the 6 months we spent apart made us want to start as soon as I got back (we were in our very early 20s, had been married for only 6 months before I deployed, and had pretty much done the I-got-orders-to-the-other-coast-but-I-think-I-love-you-so-lets-get-married military thing…spoiler alert: not a good starting place for a baby), so I stopped taking my bc pills two months before I was due to go home.
I had my beautiful baby boy! I nursed super successfully for almost a full year, and my cycle didn’t return until the very end, but when it did, I had to think about birth control again. My doctor (not gynecologist, but regular doctor —-> military life at the time) suggested I try the patch. Ok. So I tried the patch. I had pretty much the same results. No change to my regularity. No noticeable PMS symptoms. Again, everything was very regular. (ok, the patch sticky backing stuff was stubborn and annoying to wash off)
Shortly thereafter, in another feat of good decision making (total sarcasm) which I’m not even going to go into here, I stopped the patch and got pregnant again.
I had my beautiful baby girl! Two kids under 2. Birth control came up about 2 months after she was born. My gyno (out of the military at this point) told me I couldn’t take pills or use the patch while I was nursing, so my only option was the shots (Depo Provera, I assume). Ok. That’s my option, that’s what I did.
Things got different. I don’t know how much of what happened next was related to the shots, or having my daughter, or my failing marriage, or stress, or my health, or just life.
- Regrettably, I wasn’t able to nurse my daughter for very long. She got about 5 months of never enough food from me when I stopped.
- I was diagnosed with post-partum depression. It was bad. Real bad.
- I couldn’t lose the baby weight. It was the heaviest I’ve ever been in my life, even considering the two pregnancies.
- I never slept, but was always tired.
- I started getting migraines.
- I bled for two months at time, two weeks off, then two more months.
But everything else in my cycle was it’s normal, very regular self. Maybe.
After I was done nursing my daughter, the gyno suggested I switch birth control due to the lengthy bleeding. The fact that I was on anti-depressants, migraine meds, was way over my normal weight, and had a horrible diet and sleeping pattern wasn’t even discussed. In fact, I’m pretty sure neither my general practitioner doc nor my gyno ever shared any information, ever.
So, Ok. I’ll try a nuva-ring. And halleluiah! My cycles went back to boringly normal. In other news, the post-partum depression was manageable (with meds), but still there. I was still on meds, and my marriage was falling apart. I started losing weight, but I wasn’t actually eating due to depression and stress. And I didn’t like the ring. I could feel it, and it caused copious amounts of discharge which was very uncomfortable, and also seemed in my mind to somehow be related to my regular UTIs. So back on the combo pill I went for a year. And then my marriage ended, and I stopped all birth control, because I didn’t need to control birth anymore.
And my cycles were still wonderfully regular.
I started dating again, a man who had had a vasectomy. The migraines were few and far between. I managed to get off my anti-depressants. The UTIs still happened regularly, but not as often. The weight had come off (alarmingly as I look back) and I was the thinnest (not in a good way) I’d ever been in my life. We ended up getting married, and with his vasectomy, I didn’t have to think about birth control for a total of about 6 years. During that time, life went up and down. My health went up and down (mostly down…Lyme, Alpha-gal, allergies…) but my cycles stayed the same: regular, reliable, uneventful, unstressful.
Until one day I bled. And bled, and bled and bled.
I called my gyno (nurse practitioner-T). She told me to take ibuprofen…600mg every 4 hours until it slowed. And I made an appointment to go see her. We talked about my mom’s history of fibroids, which led to an early full hysterectomy. I also have no family history on menopausal time frames, so there’s that. She suggested I go on birth control pills to regulate my period. Ok. So I did.
Three months later, things weren’t much better, so she changed the pills.
Three months later, things still weren’t much better. Also I had mood swings, and my once very reliable cycle was not so reliable anymore. So she changed the pills.
I should say that I’m not really sure in what way she changed my prescription…I know they were combo-pills (estrogen and progesterone), but I don’t know in which way she adjusted which hormone on any occasion.
Then things normalized. My cycles were back to normal, regular, reliable. I wasn’t experiencing any abnormal symptoms. And the flooding was gone. Yay!
I had almost gotten completely comfortable with np-T…and then she moved away, so I got a new nurse practitioner, M. Np-M is nice. She’s pleasant. She smiles a lot. It’s cool. But np-M won’t let me take a combo-pill (or any estrogen containing bc) because I smoke and I’m over 35 (she actually gave me until 38). So at 37, I had to either quit smoking or think about new birth control. (Let’s not talk about the smoking right this second…) She gave me three options:
Option 1: mini-pill. It’s the progestin-only pill that you have to take at the same time every single day or you’re not covered for the next 3 weeks or so.
Option 2: inter-uterine device (IUD), either the copper (non-hormonal) or the Mirena (progestin-releasing).
Option 3: implant (Nexplanon). It’s a small plastic rod just under the skin in the upper inside of the arm that releases progestin.
Option 4: shot (Depo-Provera). Injections every 3 months of progestin.
I picked Nexplanon. Seemed easy enough. Little plastic thing under my skin. I won’t even know it’s there. Easy peasy.
So now I’m back at square one, making a decision about birth control, and without any answers.