Our Bodies, Our IUDs
I have a ticking time bomb inside my body. It’s menstruation, and I can’t control it.
I’ve been menstruating for two decades and I still haven’t got the hang of it. Whereas some people’s cycles are as orderly as a military, mine is more like the sea: constantly shifting, susceptible to the elements, wearing down its surroundings over millennia.
Like many Americans, I am jobless, and because I'm jobless I am also without insurance. I have to rely on the IUD that I had the foresight to get in the halcyon days of covered visits to the OBGYN, one of the benefits of my former job. The IUD is my last hope, but if anything goes wrong with it, or my period continues its mystifying shock and awe tactics, I’m not sure what I’ll do. I am slated to receive insurance through the Affordable Care Act in 2017, but we all know how tenuous that now is.
The IUD was placed inside me over a year ago. I use that phrase as euphemistically as it sounds - it wasn’t so much placed as it was injected directly through my cervix into my uterus, until the sides caught like a fly hook through a fish's cheek. The insertion was painful and left me faint. When I’d read about it online before my appointment, some people claimed it was one of the worst pains of their life, others that it was no big deal. Only one of those groups was correct.
I cramped for months after the insertion. But then again, I’d cramped all the time before the IUD, so it felt familiar. At least cramping with an IUD feels productive because I'm now protected from pregnancy. While recovering my heating pad became my new best friend, and a bottle of Excedrin Extra Strength was always just in reach.
One day I had the sudden realization that things were slightly better, and had been for awhile. How had I not noticed what my own body was up to? I no longer had continuous cramping - just a sharp stab every now and then to remind me that I still have ovaries that work. I was also unable to remember when I last had a real period. When I went for a physical the doctor asked when my last cycle was, and I was happy to shrug and say that I wasn’t really sure - I have an IUD, there’s no way I could know! This "easy period" stuff was new and exciting, and I felt a kinship with all women who skip the sugar pills in their birth control pill packs, with competitive swimmers who don’t get their periods, with post-menopausal women.
That feeling only lasted several months. I realized, almost as dimly as before, that while my cramps had gotten better, my bleeding was yet again getting worse. I dug my Diva Cup out of retirement and placed it snug inside, every day a fresh excitement, then resultant disappointment, that it was yet again filled to the brim. Another method tried, another method failed, I thought.
Before I got my IUD, I had asked my gynecologist if it would help with my bleeding and cramping. She was realistic: she shrugged and said it might, it might not. While I appreciated her candor, I would have appreciated certainty more.
Pregnancy protection hasn’t been the #1 concern of my search for a birth control method, but it’s a nice side effect. I have a boyfriend but I don’t want a baby yet. For me, it’s always been cramps and bleeding, and for me, both have gotten worse as I’ve gotten older. The bleeding has become heavier and gone on longer, the cramps are life-changing - as in, I’d have plans for the day, and I might have to cancel them because my cramps were so bad that I had to go home and agonize alone.
When I was younger and new to the pain of menstruation, my mother would give me percocet when the pain clenched me from inside and wouldn’t let go, when it hurt so bad that I felt like passing out. I would take baths at 3am to soothe myself, then clean any articles of clothing that had been unlucky enough to get picked for wear that night. I wondered why my sister’s periods were so orderly and easy in comparison. It’s just different for all women.
Over the counter medication did almost nothing to help, and no doctor would give me anything stronger. My (former) gynecologist told me to take pain medication when I first felt the pain, as if it had not occurred to me to take pain relief medication for my pain. I informed her that I was taking six at a time and still found no relief. More shrugged shoulders. She did send me to get an external and internal vaginal ultrasound to see if anything was visibly wrong (results came back “normal”). A fun fact about ultrasounds is that they make you drink a lot of water beforehand, and you aren’t allowed to pee, which is uncomfortable, made more so by the fact that you have a goddamn probe inside your vagina.
So I found a new gynecologist and detailed my symptoms - torrent of blood, deluge of internal cramping, uncertainty of when and where both issues would strike. She listened serenely, then suggested an IUD. I asked her all my questions: would I cramp less (maybe!)? Would I bleed less (maybe!)? Would I definitely not get pregnant (definitely not!). She then countered with a question of her own: did I want a 3-year Skyla or a 5-year Mirena?
There’s a special time in a woman’s life when she realizes that she’s old enough to have children, both physically and mentally, and for me it was at 32 years old. This was the first time I’d ever been asked a question like that when I would actually have to think on it. I have the aforementioned boyfriend, and though I don’t want kids now, I think we both will some day. It forced me into a serious discussion with him, who agreed that the 3 year option was better (but not before, solemnly, asking if it could be removed sooner “if necessary”). So I got the Skyla, which as the smaller IUD was supposed to hurt less. More lies.
Now, over a year later, as my bleeding worsened, I was faced with a dilemma: I had gone through the trouble of riding out the bad parts of the IUD insertion, did I really want to start over with something new? Knowing the stakes and remembering my long history of trials, I emailed my doctor with my newest symptoms and asked the question I’d been afraid of facing - was my renewed bleeding the IUD, or something worse? I wasn’t sure what WOULD be worse. From my perspective, I had two options:
- If it were my IUD, I’d have to accept the and bleeding as part of the deal of the IUD, or get rid of it and try the next thing that may or may not help.
- If it wasn’t the IUD, then it was potentially something worse.
I visited the OBGYN during my last months of insurance and brought all my old complaints with me. She examined me and found what was likely the cause of the bleeding: cervical polyps. While these were not cancerous, they do cause excessive bleeding, especially when touched (like, for instance, while wearing a menstrual cup or having sex). She removed as much as she could, but they were positioned in just such a way that she couldn’t get them all without also removing my IUD.
I elected to save the IUD and retain a small bit of polyp, opting for the potential for more unpredictable bleeding, yet better cramps and absolutely no chance of pregnancy. I realized there wasn't a win-win solution here, no clear answer. Luckily, choosing the best of many bad options is something women are really good at because we’ve been conditioned to it for so long.
Regardless of everything I’ve said, the IUD is still the best solution I’ve found. It may not be an ideal scenario, but it’s mine. Science has given us the ability to exert some control over our bodies, even though my body fights back occasionally. Something as simple but disruptive as a polyp was easily discovered and removed while I had insurance. Now, I just have to hope for the best. Which, coincidentally, is the Republican’s proposed health care plan.
I sometimes feel like I’m a guinea pig and 100 years from now people will talk about what women in the past used to do to manage their cycles (inject themselves with a foreign object that was only successful for some people! Take a pill every day that may or may not make them emotionally unbalanced! Roll the dice and possibly get pregnant!). But I’ll keep trying, because I believe in a good quality of life, and I believe that I’ll eventually get there. Or I’ll go through menopause. Whichever comes first.
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Editor's note: An earlier version of this article appeared in The Scold on July 20th, 2016.