You, Me, and Birth Control

Know what would be darned useful? A consumer reports type of publication about birth control (Sisters, let me hear you say AMEN!).

Birth control and I have had a frustrating relationship. It began when I was 17 or 18 and my dermatologist required me to go on The Pill so I could take Accutane.  Accutane causes severe birth defects in fetus if the mother takes it while pregnant. Since I could barely talk to boys and had significant religious objections to premarital sex, I asked my doctor if we could just skip it. He said he would have to know me better. Thanks for nothing, dude. Since I was desperate to get relief from my terrible cystic acne (couldn’t sleep on one side of my face because it hurt too bad, folks) I agreed to take the silly pills.

I was seeing this other doctor to treat my PCOS (the core cause of my severe acne) and when he found out I was on the pill, he was not pleased. One of my cousins (another PCOS sufferer) was also a patient of his and she had a certain gene that made her extra likely to get blood clots from estrogen-based birth control. My doctor had me tested, and it turns out I had a gene that has similar effects, but not quite as bad (my memory is imperfect, this was a long time ago). So, since nobody wanted me to stroke out (except maybe the dermatologist, git) I went off the pill. Why we are not tested for these things before we are prescribed medication of this nature is beyond me.

Fast forward 6ish years. I started getting that time of the month symptoms twice a month. It was fun, let me tell you. I told my OB-GYN “This sucks” and she was like, “let’s put you on the mini-pill,” which is a progesterone-based pill. This was actually not too bad, except for more or less constant discomfort/pain/tenderness in the, erm, chest area. I distinctly remember hiking the few blocks up the hill to teach classes in the summer and how each step was punctuated with a little jolt of ouch. I can’t remember if I had other symptoms or not; that time of life is pretty hazy, now. I went off that after my prescription ran out.

I’ve had a Mirena IUD for almost two years. Tomorrow, I’m taking Old Bessie in to get fitted with a Paragard IUD instead. Why? Because the progestin in the Mirena is not “local” or “isolated” to the uterus as claimed. Because I’m “really sensitive” and my doc says that’s “really rare.” Because the day after I got it, I was certain I was going to get fired from my job (for no rational reason). The depression that has always lingered in the back of my life grew teeth and anxiety reared its ugly head. I became afraid of driving; going to the grocery store one mile from my home became this huge, looming task of dread. My mood wouldn’t just spiral downward, it would plummet without warning. During the down swings, I could barely communicate because my brain was so full of static. I couldn’t execute tasks. Also, my sex drive tanked (just what you want when you’re a newly wed). It wasn’t great. I read in a forum online that these side-effects would fade after about half a year.

It’s been two years. Things are better, but they’re still not good enough. I still have bouts of anxiety in the car (but not all that time, thankfully). And even when I’m down, it’s not so bad that I can’t redirect myself, which before had been impossible. I still can get pretty tired and useless at times. The sex drive bit is still pretty sad. So, hopefully the Paragard (a non-hormonal IUD) will be the answer. I have read that it can make your periods longer, bloodier, and more painful, but that it fades over time. Naturally, I’m a bit suspicious (and apprehensive), but it’s time to override my fear of jumping out of the frying pan and into the fire.

So, this is why I want a consumer report on birth control. Some of the things that happened to me I didn’t know until after I was using whatever form of birth control. I thought I had done the research. I’m sick of trying to cobble together a Frankenstein monster made of drug manufacturer pamphlets (biased!), online forums (limited!), webmd-like articles (shallow!), scholarly articles* (long!) to get the complete picture on a birth control drug or method. I feel like we should demand better than that. If I can find out more about the good, the bad, and the ugly about a gosh-darned Camry from 20008 than I can my birth control options, there’s something wrong.

What about condoms? You say. Yeah, no, have you seen the stats on unintended pregnancies and condom use? Nope, nope, nope. I want better than that. YOU want better than that. Unless you’re my mother, then you want grand babies, all the grand babies! Mom, now is not the time!

Ahem.

The IUD format has its own drawbacks: I don’t like wondering if the dumb thing has fallen out or that it could maybe perforate my uterus and go wandering about my viscera unsupervised.

There are other hormonal options (the patch, the implant, etc), but since the hormones used could give me a stroke or send me back to mental health hell, I’m opting out of experimenting with those. And it’s not like I’m special; other people are having these problems, too. And we put up with it (for too long) because we need effective contraception more than we need to be happy, or even healthy. Should we really have to make that kind of compromise?

tl;dr For some of us, finding even a tolerable form of birth control takes time and money. It’d be nice if finding thorough, reliable information about our options was easier than it is now.

*I’d like to point out that not everyone who needs birth control has the backgrounds skills to handle a scholarly article. I will also confess that while I do have these skills, it never occurred to me until it was too late to look to such sources for the information I wanted to know.