The Liberating Hell of Female Birth Control (or “I’m Having an Existential Crisis Over the Old Chunk of Plastic in My Uterus”)

I’ve always talked openly about my IUD because I’ve had a really good experience but also because my road there was a bumpy one. I’ve been talking about it more lately because it’s about to expire and I have to get it changed and that’s been a weird process for my body to go through. Talking about it online got me a lot of questions from other people; some wanted to know how I liked it, others asked why I chose it, and some people started just asking me questions about my sexual health in general. I’m not sure why, but I guess we all just need to talk about our bodies sometimes and the Internet keeps us just enough removed that people feel less embarrassed talking about things there that they might not bring up in person. A few people asked me if I’d write a blog post about my IUD while others told me they liked reading the funny experiences and stories I answered them with when they asked me more generalized questions about periods and sex. I don’t sleep well, so I sat down and wrote a massively long piece about all of those things combined!

I am not a doctor. There is no way you should listen to me, or any blog post, over what your doctor has told you, unless you genuinely feel like something about their advice wasn’t right. Even then, you should only use writing like this to inform your own experience and intuition. This post is solely about MY experiences with birth control. Some of the issues are unique to me, but a lot of what’s here is also experienced by other women and they just don’t know it, so they don’t speak up about it or they deal with it silently. That’s why I think it’s an important topic to talk about in depth and without shame.

I’ve always been sexually aware. I barely remember a time when I didn’t know at least the basic facts of sex, even before I could develop any sort of interest in it. I didn’t just understand “where babies came from”, either. I knew that some people had sex for fun whether they wanted a baby or not. I also knew early on (I’m not specifically sure why, as I don’t remember pointed conversations about it) that sex was something that happened between two willing adults and that no one could really make you do anything with your body that you didn’t want to do (except get blood tests and go to the dentist). Even as a kid, I was a “Don’t touch me unless I say so” kind of person and I know my mom certainly influenced that, but she didn’t exactly sit me down and drill it into my head every morning while I ate breafkfast. Regardless, I appreciate that I understood these things so early.

I don’t remember asking my mom to explain sex to me. I don’t remember having any initial discussion (or, as my friends and I would later call it in middle school, a “sexure lecture”). I do remember that my parents let me rent a VHS from the movie place on the military base where we lived that explained, quite cut and dry, how babies were made and born using little cartoons. I was the kid who would correct other people’s children in a matter of fact manner when they gossiped about babies being delivered by storks or being pushed out the mom’s belly button when the dad peed on her stomach. I know I definitely caused more than one family to have awkward discussions with their kids after school when I broke down the real story for my friends at recess and blew all their minds. It was early, too, and I didn’t see a problem with it. I wasn’t telling them dirty stories or showing them porn, I was just explaining how bodies worked because I thought it was really weird that they didn’t know. They had bodies, didn’t they? They were going to grow into adults someday, weren’t they? Shouldn’t we all be prepared for that shit? I remember making a boy cry in the second grade because he tried to tell another girl that babies fell out their mom’s butt anywhere they pleased, like in the grocery store, and when she said he was wrong he punched her in the arm and made her cry. I stepped in and told him how it really happened and the truth scared him so he told me to stop talking. I told him it’s not up to him whether I talk or not and that if I saw him punch a girl again, I’d punch him a lot harder. He ran off crying too.

Later on, around the fourth grade, I got earlier sexual health classes than most North American kids when my family moved to the UK. The Scottish school I went to sat us in an alternating boy-girl seating plan and kept us that way when they played us informational VHS tapes on roller stand TVs about sex and puberty that didn’t spare any detail and didn’t give us the courtesy of cartoons. They used a combination of alarming bisected scientific diagrams and pictures and videos of real bodies. I definitely saw female bodies there, but there was certainly more emphasis on men. I remember having to learn all the different parts and functions of the male reproductive system, but when it came to women we just heard about “The Vagina”, as though it was a singular whole entity that one might marvel at but never admit to exploring in depth, lest they get eaten. After that, it was straight to the sexplanations. They might as well have shown us porn. Immediately following, they’d make us change for gym class, which we did sitting in our seats at our desks, still in that boy-girl formation. Most of us weren’t even old enough to wear bras yet and we saw each other topless and in our underwear once a day, the whole class together, after watching weird naked videos. The whole thing seemed like a prank, but no one ever jumped out and shouted “Gotcha!” at us.

Once I moved back to Canada, kids were only just learning the same stuff in grade 9 that I’d learned five years earlier. I remember one “health” teacher (because the school board in the prairies of Winnipeg, Manitoba wouldn’t call it “sex ed”) told us to practice putting condoms on by sliding them over a banana. She chose me as her unfortunate guinea pig, probably because I was showing off about how smart and well informed I was even though I wouldn’t let any of the boys touch me, and she didn’t provide any other instruction than “put the condom on the banana, making sure to pinch the tip”. Well, I put the condom on properly and all, but she hadn’t told me that I didn’t have to peel the banana. She assumed I’d just slide it right on top of the peel and then she turned to write on the chalkboard and didn’t supervise me. I peeled the thing, started unrolling the condom down its length, and promptly snapped the banana in half in one hand. Boys wanting to touch me wasn’t a hassle anymore for about a year after that because they were all worried I’d tear their junk clear off with enthusiasm.

I got my period when I was 14. I was late to the party compared to a lot of my friends, and really late compared to my cousins. I was about to leave for dance class but my stomach felt a little bit uncomfortable, so I told my mom I was going to the bathroom one last time before we drove to the studio. I thought I had bad gas. When I pulled my underwear down, though, I found a dark brown mess that made me think I’d somehow shit myself and not felt it. I couldn’t believe it. It never occurred to me that it was blood because no one had ever told me that blood could be that dark. I thought a woman’s period was bright red and gushing, just like wounds in movies. For all the detailed sex education I’d had early on, I didn’t get a very in-depth walk through female puberty. It was more like a crash course with vague references to eggs and bleeding, lots of people in class clearing their throats, and a relieved “Okay, moving on!” when we’d all survived the ordeal that was discussing the female reproductive system. I knew what my period was, why, and how it worked, but there were some crucial details I would have appreciated that no one ever thought to mention. I was a busy kid with about a thousand hobbies, so I’d never really spent time exploring my own equipment for myself either. I had shit to do.

Totally embarrassed and wondering if I was dying or going to explode, I poked my head out the bathroom door and said to my mom “I think I might have sharted”. Being an all-knowing Mom, and knowing that I wasn’t usually in the habit of unwittingly shitting my pants at the age of 14, she clued into what was happening immediately and asked if she could come in. I had no shame at that age and still wandered around the house with no shirt on because I had the same physique I’d had when I was 7, so she came in and said “Nope. That’s your period. Fuck” (my mom is a strange combination of eloquently spoken, well educated teacher and opinionated feminist turned military wife who doesn’t give a shit what anyone thinks). She got me clean underwear and a panty liner (I already knew how to use those because I’d been using them since I was a kid. Did you know you can get strep in other places than just your throat? That’s a whole different graphic health story. I’ll spare you). Then she got me a tampon. I was worried about that because I’d heard every wild middle schooler rumour and urban legend you could possibly imagine, like the girl who did the splits with a tampon in and it went so far up that she never got it out and had to live her life like that, or the girl who didn’t change hers for three weeks and she got blood poisoning and went into septic shock and died, or the girl who chose one that was too big and when she put it in she accidentally tore her own hymen so she technically wasn’t a virgin anymore even though she actually was. My mom promptly told me those were all stupid (“Except the part where you actually do have to change your tampon”) and slapped the tampon into my hand. She left and shut the door to give me a bit of privacy and shouted instructions through it.

Somewhere in this process I learned that women have a different hole through with they pee that is not their vagina and that blew my entire damn teenage mind. How had no one told me? Why hadn’t I seen it? How had I not felt that and noticed? I thought I only had one single thing going on down there and that’s where all the plumbing action took place and I was mildly disgusted that, after all those failed excuses for “health classes” and even some semi-informational ones, no one had made the truth about women peeing abundantly clear. Since then, I’ve met fully grown men who have regular exposure to vaginas who still don’t know that we pee from a separate spot. In any case, I succeeded with the tampon after a few minutes (I considered refusing it, but I was a competitive dancer and swimmer and I knew a pad wouldn’t fly in either of those scenarios. I could easily picture blood spattered ballet tights on stage or a waterlogged cotton pad slipping out the side of my bathing suit) and I came out of the bathroom thinking I was all ready for dance class. My mom told me we wouldn’t be going that day and marched me into my room to put on pajamas. She handed me a Tylenol, which confused me because I didn’t have a headache (for once) and I asked why we weren’t going. She said I might start feeling sick from my period but I insisted that I was fine. I thought my dance teachers would be mad at me if I didn’t go and I’d danced with a broke ankle for weeks once upon a time, so I was convinced I could handle a stomach ache. I got firmly rejected and within an hour I was grateful because suddenly it felt like there were knife-armed aliens in my stomach rolling around and kicking my insides and trying to cut their way out.

My periods definitely weren’t as bad as some people’s, but they were certainly worse than average because they would team up with so many other health issues I had. My migraines always got worse and I was always more nauseous than my already queasy default. I have weird unsolved thirst issues and I’d get so thirsty on my period that sometimes I’d actually wake up crying and gasping. I used to get random crazy fevers, but they were always worse when my period started. I’d spend days feeling hot to touch but frozen on the inside and with achey muscles and skin. I didn’t pass out randomly in public like my cousins did when my grandma took us shopping at the beach, but I’d have to miss school and sit out for dance class and I always felt badly about it because I thought other girls were getting through it okay without this much hassle, and some of them were. I felt like such a whiner. By my second year getting my period, I’d started sucking it up to do things and go places no matter how much pain I was in, but it was still absolutely horrendous and illness inducing every month. Mine also lasted way longer than my friends’. They’d be done in three days and I’d still be fever flushed and convinced I was bleeding to death a full week later.

Even though my periods were bad and I probably could have gotten a birth control prescription early on to regulate them, I actually ended up getting the pill because of sex. I decided I was ready to try having sex when I was 16. I didn’t end up actually doing it until I’d turned 17 a few months later because, like the over-analyzer I am, I took some time to really think about it first, but I was 16 when I decided I was ready. I didn’t really consult my boyfriend about whether he was ready- he was a hormonal teenage boy and it was obvious from his behaviour that he was, so as far as I was concerned, it was up to me. I knew, however, that birth control comes before sex. I’m not sure how I knew that so concretely; I know my mom mentioned birth control to me and I’d certainly seen her take it when I was young (I remember spinning the dial around the round package and messing all her days of the week up while I sat on the counter so she could cut my bangs), but I don’t remember us ever sitting down and having an actual conversation about the fact that, no matter what, birth control comes before sex. That part was just common sense, otherwise you weren’t controlling any birth at all. I just assumed that’s how life worked, so I followed suit.

One morning while I was “doing my makeup” (read: skipping all other steps and just slathering my waterline in thick black kohl pencil) for school, I started thinking about how it was going to happen eventually, so I might as well prepare myself. I casually shouted down the hall to my mom “Hey! I think I should go on birth control”. She seemed slightly taken aback but just said “Okay, cool” and made me a doctor’s appointment. I remember there being some kind of subtle rumbling argument at one point where my dad found out that I was getting it when I hadn’t told him and got really pissed off, but my mom stopped him from approaching me about it. I can’t even fully remember what happened and I think that’s partially because my mom kept it under wraps knowing that we’d have a blow out, protecting me from the embarrassment out of respect for that fact that I’d had the brains to be open about it and actually protect myself, but I was also just too wrapped up in my own little hormonal teen world to take much notice. I didn’t care what he thought; if I wanted birth control, I was going to get it. Wasn’t that how it worked? I hadn’t even kept it from him maliciously or out of embarrassment. He was a military dad who wasn’t always around and it genuinely didn’t even cross my mind to ask or tell him. It was a Mom thing. I just sort of instinctively felt, without saying or acknowledging as much, that he didn’t have a uterus so it wasn’t his issue, business, or stress. I didn’t even consult my boyfriend at the time. I just got the pills, waited three months while they regulated in my body (not because the doctor told me to, but because I’d heard from a cool girl at school that that’s what you were supposed to do and she had topless pictures of herself on her flip phone, so I figured she might know), and then announced it one day, like sex was now an option if we were bored sometime and had a free afternoon to give it a go. Or not. Whatever. I’d be prepared either way.

We did find a free afternoon, so we did have sex. It was fine. It didn’t hurt much (that was another thing I’d heard horror stories about) and I didn’t bleed, but it didn’t feel great either. I mostly just felt hot. My boyfriend wasn’t a virgin but he knew I was, so he tried to make it special. He turned off all the lights and lit candles that smelled like nothing but old wax, and for some reason he opted to play Hotel California on repeat the whole time. I still laugh a little when I hear that song now. We had to be quiet because his mom and both his grandparents were home but they really liked TV and never bothered us (except that one fluke time that his mom walked in on us fully naked a few months later and said “Oh, okay. Just checking” and then walked out again and left us to it. That was awkward). We used a condom, but it was one I’d brought because, for no real reason, I just didn’t trust boys to remember anything or do things right, so I had a whole pack of them in a little zipped pocket in my purse, like I was going to take on the whole town. Sex was nice but kind of boring after however many minutes. I figured I’d keep doing it since he seemed to like it so much and it wasn’t much of a hassle to me unless I had a bad migraine, in which case no one was allowed to touch me anyways and I’d basically hiss like an angry cat if he tried it under those circumstances.

Sex got better later on, when we moved cities again and suddenly I was the cute new girl in a tiny town where everyone had dated everyone else. All of a sudden I could have my pick of whoever I wanted, including other girls’ boyfriends (not that the selection was award winning in a tiny town where there’s nothing to do and you already know everyone’s business). I had some great sex occasionally, but it was mostly just fine. My birth control, however, was great. It was the best idea I’d ever had. My favourite part was that it made my periods so incredibly regular that I knew without a doubt that it would come when I woke up on the second Tuesday of every month, like clockwork, no matter what time of day I woke up. It was dependable and comfortable. I watched other girls around me hide their pills, ask their friends to buy their condoms, have sex without anything and get sick or pregnant, lie to their parents, and continue to struggle with hormones and periods, and I was grateful for my situation. I didn’t even have trouble remembering to take it every day at the same time. I didn’t have to set a phone alarm like my friends. I was on point and ready each day. 

So, up until six years ago, I was on an estrogen based birth control called Alesse and I was its biggest fan. My skin was clear, I’d never had even a single pregnancy scare (although that was partially because I was a well informed feminist ho by university, with unlimited access to free condoms thanks to all my friends working in the university service centres). I’ve gotten migraines since I was three, though, and right around the end of my undergraduate degree, the headaches were out of control. I missed my last week of undergrad classes because I got a migraine that made me throw up every few hours and blurred my vision for six days. I had to fight to postpone my last deadlines and then scrape myself up off the floor and actually get the work done when I finally emerged from the migraine cave, all pale ands skinny and shaking. I’d only gotten the deferrals because I’d yelled and threatened to take my story to the local media; male university doctors had refused to give me exemption notes because two weeks before I’d gotten a lung infection that traveled to my other lung, my throat, my sinuses, my ears, my eyes, and was narrowly caught before it made its merry way into my brain. I was put on an antibiotic called Erythromycin that I had a terrible reaction to and I vomited so much that I ended up in the ER hooked up to fluid and gravol IVs. So, when I came in with the migraine from hell, doctors thought I was lying to get out of classes even though they knew I have a 20+ year history of migraines. One man told me I was probably pregnant (I wasn’t, and he said that every time I went in for anything. I’ve never been pregnant). Another man told me in a condescending tone that it was psychological but then didn’t even refer me to any type of therapist. He just sent me home even though I cried and begged for help. I got my deferrals by crying, yelling, screaming, and threatening people, which I shouldn’t have had to do, but I look 13 and no one ever listens to me, so unfortunately that often ends up being the only thing that works for me (please also see: the mouse apartment fiasco, for those who have been following how much I yell at people for a while now).

Once I’d finally survived the end of the term and finished my degree, I went back into the clinic to beg for help with migraines. I was already underweight because I’d had mono three times in my undergrad (that can happen) and now I couldn’t eat thanks to migraine nausea. At one point in my undergrad, I weighed 96 lbs at 5’4″ even though I’ve never dieted, struggled with self image, or suffered from eating disorders or body dysmorphia. I’m just an unlucky, sick person who doctors only like to help sometimes. When people ask me (usually accusingly) how I stay skinny now, I end up awkwardly explaining that no, I’m not fit and I don’t diet or eat well, I’m just a fucking mess and shouldn’t be emulated as “body goals”. 

This time, I was lucky enough to get a female doctor for the first time in four years at university. I explained my issue and, to my utter disappointment, even she didn’t seem interested so I broke down bawling and straight up refused to leave her office until she helped me. She finally felt so bad for my pitiful form that she asked a few more half-hearted questions. At one point, way later in the game than she should have, she asked me if I was on birth control (which I’d actually already told her, but sure). I said yes and told her what kind and she stopped and looked me dead in the eyes and said “Wait. You’re on an estrogen based birth control? Why?” I was confused. I said that’s just what they’d given me, and weren’t they all estrogen based? She asked me why I’d never switched to something else and I told her that I was afraid of needles (also previous iterations of the Depo Provera shot had links to birth defects and a problematic social history related to the forcible colonization of Canadian First Nations women’s bodies through unwilling sterilization, but that’s a whole other body of writing that we won’t get into now), and I knew IUDs existed but everyone had always told me that because I’m small, they probably wouldn’t fit me so I shouldn’t bother. Implanon (a slow release implant that goes inside a small incision in your upper arm) made me queasy to think about and diaphragms, sponges, and spermicides seemed outdated and untrustworthy to me. I’d also never really been walked through the details of these options by any adult or professional; I was just going off of what I’d read by myself on the Internet. 

The doctor told me that estrogen based birth controls (or what they existed as at the time) can essentially kill migraine sufferers who experience visual aura, which I do. They vastly increase your chances of blood clot and stroke to a dangerous degree. She couldn’t believe that I’d been on one for so long with such good results, nor that the long list of doctors I’d seen had let me continue taking them knowing what kind of migraines I had. She immediately cancelled my ongoing prescription and renewals for Alesse and prescribed me a progestin based birth control pill called Micronor. These pills have a different hormonal effect on your body and therefore don’t raise your chances of stroke or blood clot. She also told me my increased estrogen levels were probably what was increasing my migraines and this change might make them go down, even though it probably wouldn’t take them away. I couldn’t believe that I was literally in danger and no one had ever cared enough or been well informed enough to tell me.  

I was on Micronor for a year and it was absolutely horrendous. It took me that entire year to clue in that it was probably my birth control making me miserable, but during that time I was a complete and utter basket case. I gained weight, I had breakouts, my hair went limp, I was even more nauseous than usual and had trouble eating even though I couldn’t get any of my pants to zip up. I cried about absolutely everything. I broke up with my long term boyfriend about six times and begged for him back almost immediately each time. When my cat had to be declawed because she tried to scratch two people’s actual eyeballs out (and almost succeeded) I stood in the middle of a Canadian Tire with my mom and just bawled my eyes out, openly sobbing, wailing, and yelling that I was a bad animal mother and my cat deserved better. I quit jobs and was a total bitch to all my friends. I cried every morning waking up for work because Ottawa’s job market was terrible and I felt worthless. I got accepted into a brand new Masters program with a TAship and funding and instead of being happy, I called my mom and cried that I was going to fail out so I shouldn’t even bother accepting. They took me into the program knowing that I wanted to write about Lady Gaga, a dream that had started as a joke, and instead of being excited about it I bawled that they would judge me and think I was pathetic and no one would respect me because I was an oversized toddler and a garbage person. I was never actually depressed nor at risk of anything serious, I was just hormonally bat shit crazy.

One day on the bus I sat behind two girls I didn’t know. One girl started telling her friend that she’d tried a new birth control pill but it made her sad, so she switched to a different one two weeks in and now she was feeling great. Her friend started wondering if maybe she should switch too because she’d felt kind of sick and gross since she started hers and hadn’t really thought about switching because she forgot it was an option. It was a really simple thing to over hear, but it hit me right in the face and I started crying right there on the bus to work. I’d been suffering for an entire year on a medication that was making me feel like I was out of control and had become a horrible person, but because doctors and medications had always been such a damn struggle, it had literally never occurred to me that I could say no to something, tell the doctor it wasn’t the best thing for me, and ask for or demand something better.

That day, a rich white man from the fancy office building I worked in came into my coffee shop and made a joke that was horribly transphobic. The two women with him, who I was aware knew better but who I also knew thought the man was hot, faked that they thought it was okay and giggled and flipped their hair instead of telling him to fuck off. Still upset from the realization that I’d been putting myself through hell for a year for no reason, I lost my entire mind on this guy. I told him to get out of my store. I told him that we didn’t support transphobia and didn’t serve terrible people and that I was sick of hearing his horrible, oppressive jokes all summer. He tried to argue with me and I straight up just yelled in his direction. Like, I didn’t even use words, I just made loud noises until he got uncomfortable and left. My boss walked in half way through and didn’t know whether to laugh or cry, so she said “I think I might have to fire you…?” in an uncertain tone, half smiling and half scared. I took off my apron, grabbed a delicious, freshly baked apple fritter, told her she was a good boss and I was a bad employee but that I wasn’t sorry (she told me not to be and really did ban the transphobic guy, and I actually ended up working there again in about two weeks), and I walked out (without paying for the fritter- my boss said I “clearly needed it”). I got on a bus and went straight to the doctor to demand a change in birth control.

The doctor was a man again and he tried to tell me that my birth control was fine, but that I probably had anxiety. I told him otherwise and gave him examples and he just kept arguing with me. I started to cry and he lead me by the shoulder to the hallway and tried to close his door. Suddenly I just felt absolutely infuriated. I stuck my foot into the doorjamb and pushed it back open. He asked me what else he could do for me, so I dug my birth control out of my purse, threw it onto the floor, and stomped on it. As fast as I could, I started rambling off the whole saga about how this was the second birth control that was doing its best to kill me and how no one would help me and that was unacceptable. I told him that if he didn’t believe me, maybe he should try taking it and see how it made him feel. I told him I was absolutely livid that I was going through all of this just to try and have a healthy sex life while my largely unsupportive boyfriend didn’t have to do a damn thing, even though he was the one who REALLY should have been taking responsibility for contraception because he was the one with the sex drive and I’d always had the lacking sexual voraciousness of wet lettuce. I went on a massive rant about how I was doing it to protect myself and take responsibility for my body, but that it was total bullshit that I was going through all this while every man I’d ever had a relationship with didn’t have to do a god damn thing but slide a condom on sometimes, and half of them selfishly didn’t even want to do that. I pushed my way back into the doctor’s office and lost my mind for the third time that day.

That’s how I finally got a prescription for an intrauterine device. I hadn’t walked in wanting one specifically but as I read through a pamphlet (which the doctor had handed me rather than actually walking me through my options himself), it still seemed like a better option than Implanon and the Depo shot since pills were out. I asked him for the IUD and he said “Okay, you have to go somewhere else for that. I can’t help you here”. I asked where I was supposed to go. Was it a hospital procedure? Was it just another clinic? He literally said to me “I don’t know, call a sexual health clinic or maybe a women’s… place”. I glared at him, threw his pamphlet in the garbage, and left saying “Screw this, I’ll do it all myself”.

Lucky for me, nearly my entire department was made up of women with a uterus of their own and similarly shitty doctor experiences. One of my colleagues referred me to a free sexual health clinic downtown and I went there for an appointment with my prescription slip. They were slammed when I walked in and I was treated with respect but efficiency. Their building also housed a safe injection site and syringe drop off project that was being piloted and it was a resource centre for all people, rather than just a women’s health centre, so it was basically just organized chaos with people in every corner. I felt good about it though because it was very clean and the form I filled out had separate categories for sex and gender and gave me more than two gender options to tick. It was still pretty binary, since the options were “male”, “female”, and “other”, but it was the first time I’d ever seen anything more than just a gender dichotomy on a form, even though I was enrolled in a feminist program.
During my appointment, I was almost talked out of the IUD. The one they could provide me very cheaply with my insurance was made of copper and had no hormone coating but it was smaller. The woman told me I needed a smaller one because I’m a small person and, from what she could feel after a very tickly belly massage that made me have to pee, she speculated that I might have a slightly smaller than average uterus. She was pretty sure it wasn’t tilted (a woman with a tilted uterus cannot have an IUD because the angle increases the marginal chance of the device perforating her uterine wall), but smaller uteruses are often slightly angled, so I’d be better with the smaller device. The small copper one, however, can cause lot more cramping and discomfort because it doesn’t involve any hormones at all, so it doesn’t stop your period, nor stop your uterus from contracting if you already naturally get bad period cramps. I wasn’t sure about that. My period cramps were already hell.

My other option was a plastic Mirena IUD. I’d heard of them before from watching Teen Mom when I got tired of studying and writing my thesis. I asked about that and the doctor kind of hesitated. The Mirena IUD (or, at least, the one that was current at the time) was a little bit bigger and had a hormone coating of progestin. I shied away from that idea because I felt like progestin was ruining my life but she explained that it was solely an external hormone coating that would only really affect the localized area around the IUD and my uterus directly, rather than coursing through my body like the pills and making me crazy. The Mirena had a 50-ish% chance of safely taking my period away all together by discouraging my uterus from producing a blood lining but otherwise letting my body naturally go through its monthly cycle with minimal risk. My ovaries would still function but the device and the hormones would prevent pregnancy by taking away anything at would sustain released eggs. The only issue was that it was slightly bigger, so I would probably feel it. It was also not covered by my insurance because it was brand name and classified differently, so it would cost me $300.
I opted for the Mirena. The doctor was slightly apprehensive at first but told me that if I got it and it turned out to be too big for me and caused me discomfort, she’d replace it for free. We set this up by actually getting me two IUDs because this doctor had a little system going where she stocked up on donated emergency copper IUDs that women with good insurance didn’t want or need but could get without much charge and were willing to donate to the clinic. This meant that if a woman with little money and no insurance but who really needed birth control came in, the doctor could give her a donated IUD, or that if someone like me came in with a failed expensive IUD that was hurting, she could replace it without me having to pay double. She said if I was willing to donate a copper IUD, she’d put me on a list she kept and make sure I got one back for free if I had problems with my Mirena. The possibility of being period free and mood stabilized on top of baby free for five years (that’s how long an IUD lasts, but you can have them removed earlier at your request) was just too good for me to pass up, especially when the copper one might make my already-terrible periods worse and fail to regulate my hormones.

The doctor gave me two prescriptions, one for a copper IUD and on for a Mirena. I wasn’t sure whether getting a spare IUD might constitute insurance fraud, so I never told my parents about the donation part (Hi Mom!) but as far as I was concerned, I was helping another woman and covering my own ass. The copper IUD came out something like 90% covered and the doctor offered to pay the remaining amount herself (I forget what it was, but she paid less than $30 for me) since I’d been willing to donate it. I then spent $300 I’d originally squirrelled away for Lady Gaga tickets on a Mirena IUD for myself. We made an appointment for me to come back the next week to get it put in. I handed the doctor the copper IUD and she put my name on it in extra big letters just in case I needed it later. I didn’t end up needing it and never came back for it, so I hope it really was donated to someone who benefitted from it after all.

I went home with my Mirena and took the package out of the box. The packaging was clear and you could see the device attached to the end of the applicator stick. It looked huge and intimidating and I hated it but I was desperate and more than willing to get it. I called my boyfriend, who had been somewhat understanding but not overly supportive about it, and made him come over. He’d been patient with all of my mood swings and about as kind to me as an attractive early 20s straight dude can be to his “crazy girlfriend”, but he refused to actually really talk about “the whole birth control thing” with me. He knew I was on it and that was good enough for him. He didn’t want to hear about periods and cramps and how they were going to open my cervix with a clamp that looked like a duck’s bill and stick a piece of plastic inside. When he got there, I showed it to him and he was disgusted. He told me he didn’t want to see that, hear about it, or think about it. I told him I wanted to talk about it because I was scared, the whole thing had been an ordeal, and I was kind of doing it for both of us. He said it wasn’t his issue. I started to get upset and told him I was actually hoping he’d come with me to the appointment the next week because I had a history of passing out during small procedures and that made me worry about going alone. He said “You survived getting piercings and tattoos. You’ll be fine”. I asked him to come anyways, because what if I wasn’t? He said no. “That’s the kind of thing you take your mom to”. My mom lived in Italy and he knew it. My grandparents and all my aunts and cousins lived in far away cities. The only relative living near me was my younger brother. I reminded him of this and he told me to take a friend. I argued and said that my friends weren’t responsible for our sexual health. He wouldn’t see anything. He didn’t even have to be in the room, he could just wait for me in the waiting room. I just didn’t know how I’d feel after and wanted someone there just in case. He said “I’m not responsible for this. I don’t want to be there. This is your issue”. I dumped him on the spot and made him leave.

I didn’t speak to my boyfriend all the next week. He tried to contact me a couple of times but I told him he was an insensitive jerk who didn’t deserve to have sex with me anyways, so he certainly didn’t need to come to my appointment. I didn’t want him there anymore. I’d genuinely decided that I’d rather pass out on the floor and just lay there until I woke up or have strangers tend to me than have him glowering in the corner, making me and my uterus feel like a burden even though he sure liked it when he could have consequence free sex with me because I was careful. The whole conversation had made me feel a little bit devalued and unappreciated and I found myself feeling happier that he wasn’t coming. This wasn’t about him after all, it was about taking care of myself. 
The morning of my appointment, however, I went out to the bus stop and found him standing there, looking ashamed and shy. He said he’d called me a couple times to apologize but couldn’t because I wouldn’t pick up. He was sorry and had thought about it and was ready to come support me however I wanted (I found out later that he hadn’t really come to that conclusion on his own like he’d said; he’d told his mom I dumped him and when she asked why, he told her the story and she called him a jackass, yelled at him for an hour, and said she’d have dumped him too. Knowing it was his mom who had to tell him why he was wrong made his “revelation” less sincere and just made me mad).

We went into the appointment and everything was fine. My boyfriend insisted on coming in to hold my hand even though I didn’t really want him in the room. He didn’t even end up holding my hand. Instead, he stood off the the side, practically facing the corner like he was in a time out. I appreciated that he was trying, but he clearly still didn’t want to be there and I honestly hadn’t wanted him to come anymore. His previous temper tantrum about it all had totally changed my motivations and views; I was no longer getting the IUD for our mutual protection, nor any reason to do with him. I was doing it to heal the damage the pills had done and make sure I was safe if and when I decided I wanted to have sex with someone. When it came to my birth control, he didn’t matter anymore. It pissed me off that he’d shown up when, in the end, I’d asked him not to come after all, fully explained why, and made it clear that going alone might be the better choice. He’d shown up anyways, against my wishes, to assuage his own guilt and make himself feel better, not because he’d actually changed his mind or wanted to be there to support me. The more I thought about it, the angrier I got. His presence felt totally self serving.

The procedure itself was simple and much more pain free than I’d worried it would be. The night before and the morning of the appointment, I’d been told to take Ibuprofen to help with pain and pre-emptively help with swelling. My part in things was much like getting a regular Pap smear; I put my feet up and just laid there. The doctor used the big duck clamp to open things up so she could see my cervix and then used a smaller but similar tool to open that so she could insert the IUD. The IUD is shaped a lot like the star sign Aries, so it has two round arms that come out of the top and extend to the side. These are pliable so the doctor can fold them down to make the IUD smaller when they put it though your cervix. Once it’s in, the doctor pulls or slides part of the plastic arm that it’s on so the IUD disconnects and rests in your uterus. I’m not entirely sure how it disconnects- I’m pretty flexible, but I’m not THAT bendy and I didn’t really want to know in the moment. My doctor was very reassuring and told me when to take a deep breath and then breathe out for the parts that hurt. I wouldn’t even really say it DID hurt. It was more like a pinching sensation, but very deep inside where I didn’t really know I could feel a pinch. It was absolutely uncomfortable but, like all my tattoos, not nearly as harrowing as I’d built it up to be in my mind.

The whole thing only took a few minutes and it was over. The doctor unclamped my cervix and trimmed my strings. She explained to me that, for removal, the IUD has two fine plastic strings (like fishing line) attached to the end. They’re very long at first when it’s inserted but the doctor trims them to barely an inch. The idea is for them to be long enough that they can later be used to pull the IUD out when you get it changed or removed, but not so long that they bother you. She said that some women can feel their strings and come back to have them trimmed more (for the love of all things sweet and holy, please don’t try to trim them yourself). She also said that very occasionally a woman will have a partner who can feel the strings during intercourse if they’re too long and will come in for a trim then too. I got lucky and have never had either of those happen. The doctor also told me that once every few months it’s a good idea to reach with your fingers to make sure you can still feel the strings and that they haven’t slipped up inside your uterus through your cervix. This isn’t necessarily overly dangerous, it just makes the IUD more of a hassle to remove. For some people it risks future surgery if it can’t be reached vaginally, but that’s rare. I only just remembered that you’re supposed to check your strings as I was typing this and have come to the realization that I’m not entirely sure I ever checked mine in five whole years. I should probably do that. I hope they’re still there.

My doctor also warned me about shifting and occasionally being able to feel at least the presence of my IUD if I really had to pee, for example. I never had either of these problems either. When I told people I got an IUD, they freaked out and told me media exaggerated horror stories about uterine perforation and deadly infection. They shared articles on my Facebook about women who never got their periods again after they removed their IUD and couldn’t have children, or women who still got pregnant even with an IUD. I was still glad I got it. Women can also get pregnant on the birth control pill and while using literally every other kind of birth control that exists. Rare complications from other types of birth control have also killed women in the past. The harsh reality of birth control is that, no matter which type you choose, you are putting yourself at risk in an attempt to protect yourself. The pill made my life hell and put me at an even higher risk than most women face, so the IUD was simply the best risk for me. I walked out that day feeling a little bit sore, like I had a particularly gruelling case of period cramps, and with a little bit of spotting, but overall I was fine. I made my boyfriend buy me all you can eat sushi, I took some Advil, I had a nap, and that was that.

I enjoyed five whole years of uncomplicated birth control bliss with my Mirena. I stopped getting my period about a month in and it freaked me out for the first few months even though I was also using condoms, so I took some cautionary pregnancy tests just in case, but I’d really just fallen into the lucky 50% or so of women who’s bodies stop producing a monthly blood lining thanks to the localized progestin coating on the IUD. I still went through a small monthly cycle, feeling a little emotional and tired, but my hormones were in way better check and I didn’t feel crazy anymore. I only got cramps about once every three months and they only lasted for about an hour. I was thankful for their short time, though, because IUD “period” cramps are the definition of intense. I once had a friend who had two IUDs and then had two babies years later and she said that her labour pains were only slightly more painful than the insane but short cramps she experienced every few months with her IUDs. I believe her. When I get cramps now, they hit so fast and hard that it feels like my hips are starting to loosen and dislocate a little bit. I feel tightness all down my thighs and up my back to my shoulders and it often triggers another muscle seizing issue I have (it’s never been solved or diagnosed and probably never will be, but it’s a very separate and uncommon thing that one doctor referred to as a “stomach migraine”. Its not directly caused by the IUD, I’m just weird) where every muscle in my thighs and stomach tightens up and starts to tremble. It doesn’t hurt, it just makes me look like I’m shivering and it’s strange and not very comfortable. After an hour or so, though, I can feel everything start to ease almost on cue. My muscles relax and the pain goes away and I’m fine for about three more months. If you ask me, any amount of very short term period pain is worth only having to deal with it very infrequently, especially if you don’t have to buy tampons, panty liners, or diva cups anymore!
Besides my emotions and my periods, my migraines also went down. Mine are chronic and I will likely always get them, so they sure as hell didn’t go away all together, but they’re not as intense and they’re less frequent. I went from having one every two days, always losing vision, and almost always puking, to getting them once a week or less, only losing vision maybe half the time, and semi-rarely throwing up. I still get other headaches of all kinds, but those are related to other issues entirely that my IUD most likely doesn’t influence. I do know some women who experienced a majorly decreased sex drive when they got an IUD and didn’t like that one bit, but mine didn’t affect my sex drive at all. It’s just as lacking as it always was, but probably not more so than before. I’ve just never had a huge sexual appetite and besides, I have other weird health things that kill it too; ever tried bumping around on your back or knees with a vision blurring migraine or random three day nausea? No ma’am.

The boyfriend and I broke up and I dated someone else for a while, but that ended too. From the time I got my IUD following that original fight, it became a lot more about me and my body and much less about just preventing pregnancy. I tell other women how much I love it all the time, recommending that everyone I know at least consider and research it because I hadn’t been well informed on it and knowing more about the option sooner could have saved my body and mind a lot of hassle. Through the whole process, I’ve also had the peace of mind of knowing that if I ever did have discomfort or problems, or if I just decided I wanted to have kids, I could get it taken out upon request.

Now my IUD is ready to expire any day and, honestly, I’m stressed about it. I think I’ve had more of an existential identity crisis about what it’s expiry could mean for my body than I ever had about people trying to tell me I might never have biological children now because I got one. For starters, I never fully decided one way or the other whether I even want kids, so for me, that’s not a massive priority in determining how I handle what’s best for my current sexual health and happiness. Beyond that, you’re only increasing your risk of not having kids by getting an IUD if you already have a genetic predisposition for conception difficulties or if you have a uterus malformation of some type, in which case your doctor probably won’t give you one anyways. In any case, I respect that some women might be very concerned for their future reproductive capabilities, but I find it simply annoying when people harp at me about whether or not I’ll be a mother later since I don’t get my periods, as though that should be the only thing I’m thinking about when I consider, talk about, and use birth control. Stop harping on women about whether they’ll ever have babies. It’s disrespectful whether they’ve put plastic in their uterus or not, and no matter their reasons for choosing either way.

I can feel my old IUD starting to wear off. If I was having sex, I’d still have some prevention power in the presence of the device itself, but I low key stopped caring about sex and dating and haven’t slept with anyone in two and a half years, so that part doesn’t matter to me for now. My concern is the disappearance of the hormone coating and how that’s changing my body functions. I kind of forgot until last week when I cried over a meme about how potatoes can be beautiful that my hormonally unregulated self is an emotional dumpster fire. I’ve gotten classic period cramps for longer than an hour for the first time in five years and they’re awful, but they’re more achey and less jarring than what my very intense, short IUD cramps felt like. Now that these are back, I can honestly say that I’d still prefer undergoing the quick hour of brutal pain and getting it over with than this drawn out throb of only slightly less extreme discomfort for days on end. I haven’t gotten my period or had any spotting yet, but I’ve started getting the random short high fevers I used to get when I was first going through puberty and haven’t seen in many years. That’s not an IUD thing though, that’s just one of my lucky little health quirks. I hadn’t thought about how the IUD might be saving me from those all this time, but they’re back with a vengeance- I have my third fever this week as I write this.

My biggest fear is that my period will come back before my replacement appointment in one month and that the new IUD won’t take it away again. That would be a struggle for me emotionally, socially, and financially and I’m not sure I’m prepared. I’ve never been one of those body-based women who finds beauty in their natural processes and the possibilities of life each period brings. I’m certainly cisgendered female and I’ve never suffered from identity based body dysmorphia, but I’ve just never felt an overly strong connection with any of my specifically female characteristics. Maybe it’s because my body has always been a struggling germ factory that I’ve had to fight with, so I just didn’t develop that relationship with myself. In any case, my uterus mostly just hurts me, my boobs are semi-annoying and I prefer them when they’re at their smallest (they change marginally in size when I’m hormonal or as my weight fluctuates), and my vagina is just a vagina (but I certainly appreciate that having one of those means I don’t have to tuck in drag). I have a huge respect for women who are much more in tune with their body and it’s reproductive capabilities, but I’m just not one of them and my IUD saved me from having to deal with parts of that femininity that I currently have no use for and mostly just experienced pain from. I’m grateful for that and I don’t want it to end.

On top of ALL of that, and for all of my disinterest in sex (ok, let’s not call it that, I guess… I’m just way too busy enjoying myself in other ways to bother with or care about the largely awkward process that is dating or hookup culture), I’m still a well informed sex positive feminist who wants to be protected from unwanted pregnancy should I suddenly meet someone who’s bones I feel a compulsive need to jump. My appointment for a new IUD is on July 6th and, even though I’m barely scraping together that $300 because I’m not sure if my new insurance will cover it or not, I’m counting down the days like it’s Christmas.

PSA: Male birth control pills have been tested and deemed viable and safe. Studies were recently released, however, revealing that no one has picked them up to market and sell because the men who participated in the trial didn’t like the pills, complaining that they got a few head aches and were tired sometimes. POOR BOYS. THAT MUST HAVE BEEN SO HARD FOR YOU. LET ME WEEP FOR YOUR PAIN AND SUFFERING. *explodes in feminist rage* 

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One thought on “The Liberating Hell of Female Birth Control (or “I’m Having an Existential Crisis Over the Old Chunk of Plastic in My Uterus”)

  1. Rebecca Roque says:

    BRAVO COURTNEY! You’re an amazing writer! I’m well beyond childbearing years but read your article because I love what you write!

    I’m a labor and delivery nurse that rarely deals with birth control but I feel pretty educated on it after reading your piece.

    Keep it up lil Lady!

    Love to you, Becky from California, Fellow RPDR fan

    Like

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