I’m Sick of Doctors Who Try and Talk Me Into Hormonal Birth Control

An image of an IUD, via WikiMedia Commons.
The Intrauterine device (IUD) is going mainstream, and stories about its resurgence are everywhere. But that doesn’t necessarily make them easy to get.

The IUD, if you’re not familiar, is a T-shaped birth control device that is implanted into the uterus, and they’ve been embraced largely because of their success rates and reversibility.

About 30,000 IUDs were funded in Colorado in the past couple of years to provide lower income young women with long-term contraception. The result? A 40 percent drop in teen pregnancies between 2009 and 2013. They’re also the preferred method of contraception for family planning providers. This is an interesting little factoid for me because when I tried to procure one, the doctor at the clinic I went to (which specializes in birth control, by the way) looked at me like I’d asked her to insert a hamster into my uterus. She then fear-mongered me out of it by jacking up my anxiety, and tried to peddle either the pill, or the Mirena, a hormonal IUD.

Let me be clear that I told her I’ve decided to cease taking the pill because I feel that the additional hormones are no longer appropriate for me. I feel the mood swings associated with them have been exacerbating my anxiety and periodic depressive episodes, and told her as much. I told her a copper IUD is the best fit for me. Here is what she said to me:

“It will really, really hurt. Like, really. Some people don’t think it will, but it does.”

“I know,” I said, nodding. And I did know. I had done hours of research prior to the appointment. But by this time she started in on how much pain my poor, unsuspecting uterus would be soon to endure, she had put so much stress on the ever-so-slightly higher chance I would become impregnated that I was already terrified. The chances of preventing pregnancy with a copper IUD are 97 percent, as opposed to the pill’s 99 per cent. But seriously, most women either miss them every once in a while, fail to take it at the same time every day, vomit one up without thinking about it, go on antibiotics every now and again, rendering the pill less effective, etc. When human error is taken into account, the 99 percent, I think, is largely the stuff of fairy tales.

Anyway, by this time sweat was dribbling down my temples. I had sprouted a slick, sparkly sweat moustache. My hands were shaking ferociously. I asked her where the bathroom was. “Why don’t you lie down?” she asked. “I NEED TO GO TO THE BATHROOM,” I said.

I went. I vomited. I reluctantly dragged my ass back into her scary little hyper-sanitized room. I was still under the illusion that I might get this thing inserted today and stop worrying about condom failure and impending pregnancy doom.

“I wasn’t even done yet,” she said, after asking me if I was okay. She asked it with the warmth of a particularly bad-mannered government employee working the late shift at a call centre.

“I didn’t talk about how there’s a possibility of perforating the uterus, because we can’t see what we’re doing up there.”

I asked for a drink of water. She gave me warm apple juice.

By this time, I had determined that this woman absolutely was not inserting anything whatsoever into my uterus.

I want to be perfectly honest: I was very nervous before going into the room. The anxiety wasn’t provoked entirely by the especially careless bedside manner. And further, I absolutely do not blame her for being clear on the risks involved with IUD insertion and its aftermath. It is her job to make sure I know what I’m doing. It is her responsibility to let me know, and I appreciated the frankness.

My issues with the visit are threefold: there was little to no mention of the benefits of the copper IUD, and no effort made to help me feel more comfortable. Further, there was zero mention of the plethora of risks associated with the pill. She spoke of it as though it were children’s Tylenol. The biggest issue for me is that I’m not alone in what I experienced during this particularly awful clinic visit. Non-hormonal contraceptive options in Canada are virtually never discussed, and doctors, let alone the average person with a uterus, are sometimes not even aware of the alternatives. At a place that dubs itself a “centre for birth control,” is it so crazy to think all contraceptives may be treated equal? (I’m not the only one to be met with skepticism for my choices, either. My friends have had similar experiences to this. One friend was told she was too thin for an IUD. Another, after suffering through seven iterations of the pill, was told she was too young at age 24).

While this doctor scared the bejesus out of me, she also repeatedly tried to peddle the benefits of hormonal contraceptives. Lighter periods! (I wasn’t concerned about the prospect of a heavier period. Periods are things people with uteruses deal with all the time. Not scary!) The pill is not so invasive! (I was already familiar with the pill, I wasn’t concerned about the invasive nature of the IUD, and I have begun to feel that hormones are, actually, invasive for my body. Which I made clear).

While the dangers of the IUD were preached for about half-an-hour, when she gave me the prescription for the Pill, not so much as a cautionary peep was made. This, despite the fact that blood clots, stroke, heart attacks, and high blood pressure are potential side effects. What’s more, it’s also been shown to sometimes cause depression in those who are prone to it. Why are the Pill’s effects on our minds and bodies not made clear before it’s doled out to us like candy? Frankly, her insistence was a tad suspicious, and I’m not the first woman to feel this way after requesting an IUD.

Getting back to the doctor’s office, she wound up with a spiel about how the pill I’d been taking, Alesse 28, had one of the highest concentrations of progesterone, and she gave me a script for a pill with a lower dose. Yes, she talked me out of an IUD and back into considering the pill, even though I’ve been off for a month and noticed a marked difference in my emotional stability and well-being. Before, I would cry or snap incredibly quickly. While I’ll always be a, shall we say, temperamental person, those symptoms have eased up considerably, and I feel happier and more comfortable.

As for the pill, I’m not a hysterical purist going on a mass crusade against it. I took it daily for 11 years, and it agreed with me in some ways. For many people with a uterus they’d prefer to keep pregnancy-free, it’s an ideal choice: it keeps their skin clear, regulates severity and duration of their periods, and prevents pregnancy. But I also think women should be given an even choice between the pill and an IUD, whether copper or hormonal. The pill should not be the only contraceptive ever suggested.

Despite the fact that the perils of the copper IUD were castigated at length, nothing was said about the potential casualties of the Mirena. The two have the same shape, and I’m pretty sure that in the off chance I’ll have my uterus perforated, I’d like to have it done in such a way that would not also involve extraneous hormones, please.

(Oh, and also, there’s a huge lawsuit surrounding Mirena in New Jersey right now in which literally hundreds of plaintiffs are suing because they were not warned that the device can spontaneously migrate post-insertion. Some of the complications of that in the plaintiffs include uterine perforations, organ damage, scarring and infertility. Naturally, none of this was mentioned.)

For the record, I’m still getting that IUD in a couple of weeks, and I’ll let you know how it goes. But I will be going to Planned Parenthood, and not to this judgey doctor lady.

In the meantime, like so many women I know who can’t find a desirable form of contraception, I’m just praying for the condoms not to break.

@sarratch