Perpetually Seeking the Perfect Contraception...
In the last 10 months alone I have tried (and given up on) 3 different contraceptions- in fact one of them gave up on me, but we can get to that later.
Before I begin I must state that I am not a doctor or health care professional and this is purely my personal experience. However I do know that often we can feel alone when it comes to contraception- and with little readily available research we can often find ourselves questioning symptoms. If anything, I merely want this blog to be a note of solidarity between you and I.
I first went on the pill aged 14, when I suffered from irregular and very heavy periods. Having two older sisters meant that when I went to the doctor with my mum (who also used to be a nurse), she asked to make sure I wouldn’t be given ‘microgynon’ which is usually their first choice and both my sisters hadn’t got along with it. I can’t remember how many I tried before settling on Cilest, a combined pill (containing both artificial oestrogen and progesterone). Despite the consideration taken by my family members of what contraception I should be on, I chose this particular pill for rather less credible reasons. Cilest, for me as a young teenage girl, was the dream - it made my boobs grow exponentially *sigh*. At that age hormonal boob-jobs were pretty much like winning the lottery. My friends and I even used to do packets ‘back to back’, aka - three months without a break in order to manipulate our mammaries even further.
I stayed on Cilest right up until I was 20. I have to admit I can’t really remember if there were any emotional side effects - mood swings and irrationality are part and parcel of being a teenager irrespective of whether you’re adding hormones or just riding the waves of the ones you’ve already got. That being said, maybe I would have been a super level-headed and pragmatic teenager had I not been popping (prescribed) pills - we will never know.
I can’t remember my reasoning, but during the first summer of my degree I decided to ‘take a break’ from Cilest. Within about a week of coming off the pill I lost a layer of size - probably all water-weight. I couldn’t believe that I had been carrying around this extra layer purely because of the pill (and despite my boobs deflating as well), it was enough to put me off. This was right at the start of my ‘health and fitness journey’ so I was flabbergasted that the most efficient means of fat-loss I had found in all my ill-founded attempts was simply removing my contraception. I went back to my GP to explain my recent findings re weight-gain and asked if there was an alternative. I was prescribed Cerazette this time, (artificial progesterone-only pill) and was delighted to find out that, not only should I not gain weight, but I also wouldn’t get periods - winning - am I right ladies?
As it turns out, I was probably wrong. I stayed on Cerazette (later changed to Cerelle but that was just branding) from 20 until 22. I had been reading online (mumsnet - classic), stories from women who had come off hormonal birth control and suddenly felt like themselves again and were much happier. At this point I was coming out the other side of a break-up (or trying to), and would do anything (within reason) to try and make myself feel better. The change that happened once coming off the pill was almost immediate. For me, my periods came back in a month (this varies from person to person), and I felt a darkness lift off me that I hadn’t even known was there. I couldn’t be sure if it was because I was over the break-up, or finally finishing uni or some other environmental factor, all I knew was that life was a much happier and a more positive experience once I stopped taking the pill.
Almost a year of blissful ‘no-added hormones’ goes by, before what do you know, I am falling head over heels for my now-boyfriend. I wasn’t happy at all at the prospect of having to go back onto contraception - I think I must’ve given a rather convincing argument against the pill because he wasn’t keen for me to go on it either. I know the words on everybody’s lips right now is * condoms duh *, but like a lot of people, we don’t really like them unless absolutely 100% necessary. So we put our heads together and investigated what other methods were out there. I also had falling-over-each-other-laughing fits with my girlfriends as we investigated what femi-doms and diaphragms were - and despite my initial excitement at having found a hormone free alternative, I just don’t think the modern-day woman has time to be using a diaphragm.
Back to the drawing board. My boyfriend and I keep seeing articles about ‘Natural cycles’, as well as various adverts on instagram. I download the app and within a week - what a stroke of luck - I have an email from them offering a paid collaboration - ‘it must be fate’ I thought. The terms of the job outlined that I share how I get on trialling natural cycles- I was excited AF. A few months go by and frustratedly I announce to my boyfriend that I don’t think this is going to work for me, he nods in agreement. The only times I managed to successfully record my temperature were the mornings when he had stayed over and was prodding me to do so. Left to my own devices I would immediately have a sip of water upon waking or go to the bathroom- all of which means my temperature would be unreliable that day. Seen as my boyfriend and I don’t live together and have sleepovers maybe 3 times a week, I simply wasn’t accruing enough data for this app to let me know when we could safely canoodle. I completed my work with natural cycles and wrote what I have here in my post : that I am just not the right candidate to be using this type of contraception. I was fairly upset and, to be honest, felt pretty inadequate. I had been given a chance to have hormone free contraception, something I so desperately wanted, and I couldn’t even do the basic tasks required.
However the tasks, it turns out, aren’t as basic as they seem. In fact, recent articles (that came out a few months after I stopped using it) have highlighted just how unrealistic the demands of the app are. You can look up recent research and find a huge mixed bag of reviews, some people absolutely swear by it and others think it’s nonsense. It can work for people who are highly functioning, organised and super diligent: I am disorganised and slightly scatty at best. Despite all the want in the world this wasn’t the answer for me, as the fundamental bottom line is that it is a great option if you’re ok with the possibility that you could get pregnant. I am not financially stable years old enough to get pregnant.
One night in bed:
Me: Did you know vasectomies are reversible?
Him: *raises eyebrows in a kind, but firm, ‘no’ sort of way*
‘A friend of a friend had the copper coil and literally loves it’.
‘A friend of a friend had the copper coil and bled heavily for 9 months consecutively’.
I toy with the idea of a coil, and go to look up appointments on zesty (www.zesty.co.uk really great resource). Lo and behold there just so happens to be an appointment that afternoon and I just so happen to have time that afternoon. I hastily book it - ‘this must be fate’ I think to myself. Note to self; stop believing in fate.
I arrive at the clinic - roughly a 40 minute journey from where I live but so worth it to get an appointment so soon. Appointments at sexual health clinics in London are somewhat mythical. I talk with the nurse about my options and previous experience with hormones and she consolidates my choice of the copper coil.
Ouch, yeah it hurt.
A lot more than my pride let me let on.
I sauntered out of that clinic as though I had just had a 60 minute Swedish massage, only to keel over as soon as I got outside and ring my mum.
Suddenly the choice of a clinic so far away didn’t seem like a good idea but amongst the cramping sensations I somehow forgot about uber and took myself off to the tube for the journey-from-hell. My colour had drained, I was shaking, and people were looking at me as though I’d just done hit of heroin. If I hadn’t felt so sick I probably would have mentioned that whilst I hadn’t injected any needles, I had had other metals inserted into my cervix… a least no-one wanted to sit next to me.
I arrive home feeling nauseous and sorry for myself. I text my sister who assures me that she ‘does understand’ how painful it is, ‘try giving birth on two paracetamol’. I stop moaning and decide to try and nap.
The next day I have no bleeding, am in a little bit of pain but nothing like before and everything seems to be hunky dory - finally I don’t have to worry - wahoo.
Over the following fortnight the bleeding is very heavy. I hadn’t had very heavy periods since I was younger, but this is a common side effect of the copper coil and I am assured by forum users worldwide that it will get better. I had started using a menstrual cup because #environmentalbae and I have to change it three to four times a day - it is always full.
me: I think my coil is falling out
Mum: What do you mean falling out?
me: I can feel the end of the plastic
Mum: Ring the GP
me: Hi, how are you? I think my coil is falling out…
* long list of questions ensues from receptionist- I answer them *
receptionist: thanks for that- well we’re closed now so I suggest going to X clinic urgently as the doctor said it’s dangerous if it is falling out.
With the knowledge that this blog is already very long I will avoid a play-by-play of what happened next and try to summarise it. I hurriedly got an uber to the suggested clinic only to be told they don’t deal with anything to do with coils and given a list of numbers to ring. All the other clinics are shut. I ring the GP again and they say there’s nothing I can do but I can pull it out myself if it is coming out. I ring my sister who’s a doctor and she tells me to come over, she will take a look. I get to her flat and she says if it is coming out we can just pull it out, but for some reason I can’t feel it coming out anymore. I start to wonder if I had imagined the whole thing despite having checked 20 times. Maybe in the 3 hours I had been frantically trying to find someone who knew what to do my womb decided to swallow it up again.
A week later I am in the shower * my coil falls out *..
message to boyfriend, mum & majority of girlfriend WhatsApp groups : lol fairly certain this is supposed to be inside me * photo of me holding coil *
mum: haha you are funny
girls: omg are you ok babes?
boyfriend: oh fuck
I book an appointment over the phone, explaining my situation. I take myself and my expelled coil to the initial sexual health clinic that had inserted it, to get a new coil put in. I spoke to a nurse and she said that the Mirena coil has a tenth of the hormones in the pill (plus it is localised) so it shouldn't have an adverse effect on my mental health (or anything else for that matter) and it is much preferred to the copper coil. With this new information I decide to go for the Mirena coil.
It turns out I can’t have another coil put in for 3 weeks incase my previous one was inserted wrong and there is risk of pregnancy - no one told me this over the phone. I make another appointment at a nearer clinic for 3 weeks time. I am fairly certain the combination of heavy bleeding and using a menstrual cup pulled my coil out (the former is stated however there hasn’t been enough research to see if menstrual cups can suction out a coil, so they can’t give a warning). Many women messaged me to say that, they too, had accidentally expelled their coil through using a cup (eye roll emoji).
It’s appointment day and I head to the clinic, have the precautionary pregnancy test - all clear. The insertion goes much smoother than last time and it is much less painful. I don’t know if thats because I knew what to expect or because it was put in wrong the first time.
About 3 days into having the Mirena coil I feel swollen. The layer of water/fat has reappeared along with my long lost hormone-induced boob job. I take to instagram and ask if other women experienced the same; a lot had, some hadn’t and some said they did for a bit and then it went away. This time I wasn’t going to let a little bit of weight-gain dictate to me, if this contraception made a little fluffy so what, it is super effective and I won’t have to worry- that is surely more important that my body fat percentage. Proud of myself for trying to shake the narrative that ‘smaller is better’ that is intrenched within me, I carried on my merry way.
About a week into having the Mirena coil: I haven’t been to the gym as I have no energy, I feel super irritable, lethargic, on the brink of crying and actually crying about 3 times a day.
2 weeks into having the Mirena coil: Am on a press trip with a brand and I am feeling hugely insecure, my body doesn’t feel like my own, have miniature existential crisis to my friend who is also on the trip and also on the Mirena coil (she loves it). She tries to reassure me that it will calm down and it’s just my body adjusting, I believe her and feel a bit better about myself but it doesn’t get rid of the underlying sinking feeling that I keep getting.
3 weeks into Mirena coil: On holiday with my boyfriend on the beach, burst into tears.
Me: I have the worst cramps, I keep bleeding, I feel really sad and unattractive and angry and irrational
Him: Oh babe, why don’t we get you booked in for an appointment for when you get home? What else can I do? You aren’t unattractive.
Me: You can take my coil out for me?
That was on the first day of the holiday and after that big cry I felt a lot better, and had a few more attempts at blackmailing him into taking my coil out which were unsuccessful despite me reading out (from * shock * more forums) stories of women who had removed their own - I would try but I couldn’t reach my cervix.
We had the best holiday and I really loved it but there was still this really odd sinking feeling at the bottom of my stomach and I realised I had felt like this pretty much the whole way through uni. Almost as though something is about to go wrong or that I can’t quite relax or enjoy something to the full- and that’s not like me…
6 weeks into the Mirena coil: I had it removed yesterday. I went along to a walk in clinic, added my name to a waitlist and 5 hours later got a message to go back. I waited in the clinic for another hour before being called by the nurse.
Nurse: you’re hear for unusual bumps on your genitals?
me: ummm no I am here for a coil removal please
Nurse: I’m not qualified to do coil removal
Somehow the receptionist had copied my form wrong when she processed it, and because I think I looked like I was about to cry when the nurse tried to send me home to ‘come back tomorrow’, she rang a doctor and he came in to remove it. The removal is pretty simple, they insert a speculum, tug it and it comes out. You get a dull ache sensation but having had period cramps for pretty much the entirety of six weeks I wasn’t bothered about that.
It was the same doctor that had inserted it, he asked me my reasons for removal and I explained.
Doctor: Ah yes 1 in 10 women experience depression like symptoms from the Mirena coil, it is just a matter of trial and error. It is a lower dose of hormones so you’re obviously just one of the people who happens to be badly effected.
I have mental health like anyone else, but to my knowledge have never suffered with a mental illness. That being said, being on hormonal contraception is the closest I have ever felt to utter, banal hopelessness. Not all the time- but in waves, often manifesting as a lump in my throat or sinking feeling and then just a low mood. I have often questioned that huge shift in my mood when I first came off the mini pill at 22, I didn’t know if I had a) imagined it b) mis-attributed it to the pill or c) used the pill as an excuse to change my outlook on life. I am now unequivocally certain that hormonal contraception doesn’t work for me. I don’t know if that sounds over-the-top and maybe I am a very small minority who is so greatly impacted, but that is my experience. I am going to document how I feel (and look) once the hormones still working away subside- just for myself. I also questioned whether, awfully, the weight gain was triggering all these negative emotions; however I realised that I never gained weight on the mini-pill and still had the all the emotional turmoil so I am fairly certain it isn’t that.
I know a lot of this blog is about misinformation, muck ups and difficulty to get appointments - but I am super lucky to have even tried so many forms of contraception despite them not working for me. A lot of women aren’t able to get access to contraception at all because of cuts- there was a great episode of women’s hour on this the other day (13th September). Moreover, in last few months I have spent hours going to and from clinics, making phone calls and sitting in waiting rooms - if I wasn’t self-employed I don’t think I would’ve been able to make the time. What’s more sexual health clinics, nurses and doctors alike are heinously overworked and underpaid, so despite my accounts, I don’t begrudge them for my experiences.
With this in mind, you may find that sometimes medical professionals are reluctant to change your contraception or offer you alternatives. Obviously some pills are more expensive than others and so often you’re prescribed the cheapest one. Try to research (on credible sites) different methods and ask your doctor/healthcare professional about ones you think might work for you - they might not offer them up but if you’re informed they should give it to you if it’s available. If you really do feel adversely effected by any method then make sure you do speak up and don’t just think it’s in your head.
Finally, every single woman is completely different, you may respond incredibly well to all the methods I have tried, or you may not. I don’t know what my next step is - I guess I am just perpetually seeking the perfect contraception…
I promise to keep you (over)informed,