originally posted December 2007. Updated January 2009.
CHAPTER ONE. SLOTH.
Birth Control is one of my favorite things. I have had the great luck (or discipline and education) to have never been knocked up. I have never even had a real scare (just fake scares after I maybe let someone in uncovered for a little bit during my younger years when I didn't pay any attention to my blood calendar). I am sorry to say that I ever did let anyone in 'for a little bit', if you know what I mean. But you know how it goes, ladies. The men ask "Please just for a little bit," and the thinking part of your brain is suffering under the pleasure juices flowing through all your cells, and before you know it the thing is in there. Damn things. It ain't right. It's laziness! Men, if you find yourself often asking "Please can I put it in, just for a little bit?," without a hat on, you should plan on some major expenses in your future, either for pre-natal health visits, or for a session with the uterine vacuum. I recommend that you practice self-service with a condom on, so you can just get used to the fact. You might also try larger condoms, even if you aren't particularly large. The Trojan "Twister" has a nice shape, narrower at the base for a secure fit. There's more room to squirm around in the large ones, and so more friction. But please don't ever ask to put it in for a little bit, without protection. It is childish and pathetic, and makes you seem like an out of control puppy who might pee on us if you get too excited. Discipline is so very attractive.
My own disciplined quest to find a BC method that was -not- systemic and did not require daily attention yielded few results until dear friend B. mentioned her own luck with the Mirena IUD. I had always imagined IUDs as metal medieval torture devices requiring surgical insertion and threatening to slash my insides like some kind of internal morning star. In fact, IUDs are quite small (approximately 1-inch square), are inserted through the cervical opening in a procedure usually taking five minutes, and will not cause damage to your tissues except in very rare mishaps.
There are two IUDs approved for use in the United States. Both are little T-shaped devices. One, Paragard, has copper wire covering the frame (the copper creates an anti-sperm environment in the uterus) and can be kept in place for 10 years. The other is a flexible plastic thingy that releases hormones to alter the uterine conditions in favor of No Babies! This hormone releasing IUD is the Mirena and can be kept in place for 5 years.
My choice of the Mirena was the result of two major considerations:
1) Each month, about 4 days before my period, my mental state enters a pit of despair (a.k.a. a hell dimension) in which I think catastrophic, nearly suicidal thoughts and cannot imagine a future state outside of this dimension. This change to my psychological cycle experience began sometime around age 25, and it took me about 4 months to realize that it was in fact related to my cycle. This experience may or may not be diagnosable as Premenstrual Dysphoric Disorder -- I don't care to know. It sucks, whatever you call it. I chose not to seek prescribed treatment but to let it pass each month. Still, it was never easy, and depending on life events concurrent with the pit of despair, escaping it could seem insurmountable. I thought the hormones of the Mirena might have enough of an effect on my lady-parts to alleviate the hell dimension to some degree. Any relief would be a welcome side-effect.
2) I don't like the smell of pennies. When I imagined a copper IUD inside me, I imagined the smell of dirty, wet pennies. Disgusting, right?
CHAPTER TWO. LUST.
My current bed partner and I had been adventuring together for about 5 months when we realized we were spending about $40 a month on condoms. I would not say that our discussion of birth control centered around a fiscal decision; it was a consideration but not a reason. It is more likely that money and practicality provided a convenient pretense for our gradual and reluctant admission that we are, to use the parlance of the peasantship, "in love," in a way that makes us constantly puke on each other. To call him "my current bed partner" is probably insulting and certainly an understatement. He is, in fact, a historical figure in my little life, not only because of my tongue-tying affection for his brain, face, scent, and obsessive-compulsive joke-making (puke, puke, love puke), but because he was the first non-familial man to prepare me a dinner made entirely from scratch: twice-baked garlic-stuffed artichokes. And if he was so ready and willing to stuff an artichoke for my palatable enjoyment, I was surely willing to stuff a little plastic thing into my uterus to improve our roiling delight.
Ladies, I must stress that you get your cooter screened for germs before you stuff an IUD up there. Of course, you should get an STD screening at least once a year (with your Pap), and every time you have a new sex partner. A responsible gynecologist will want to see evidence of a current screening and Pap before you get the IUD. The risks of IUD use, be they rare, include ectopic pregnancy, perforation of the uterus, embedding in the uterus, ejection, PID, septic shock, and potential sterility resulting from these, so you'll want to have a clear assessment of your existing health before considering the IUD. These risks, while serious, are no more or less serious than some of the possible side effects of the pill, Depo, or other forms of non-barrier BC (including abstinence and withdrawal).
CHAPTER THREE. GREED.
As with all forms of non-barrier BC, a talk about monogamy and history (and the like) is in order. Whatever your arrangement, you should know that women, being walking wet caves, are already vulnerable enough to ambient bacteria, yeasts, and viruses, and we certainly don't want to increase that vulnerability by introducing germs from a foreign cave, if you know what I mean. I'm presuming, of course, that the males would be the carriers of the foreign bodies. I'm just keeping it real, peeps. But if any of you ladies want to whore around using the IUD as your sole protection, I hope you're screwing virgins exclusively. Just because we now know that many sexually transmitted infections are easily curable DOES NOT mean we should treat our sexual health lightly. All infections may leave scars on the tissue damaged (essentially eaten) by bacteria and critters, and nobody wants a scarred cooter! Or bladder. Or kidney. And no amount of orgasms is worth a health crisis of any kind. It is important, ladies and gents, if you wish to use a non-barrier method other than abstinence, that you understand everything you may be exposing yourself to. Now is _not_ the time to exercise discretion in your honesty. I may speak for myself when I say that honesty makes me VERY wet. We are all only human beings (to my dismay, though it may be), but healthy minds keep healthy bodies, and so disclosure becomes part of health. Roll with it. Have some courage. And keep in mind your own and your partner's overall HEALTH as a primary value.
Once I settled the health situation for myself and my gentleman friend, I could proceed to address the hurdle bestowed upon me by the Judeo-Christian-Conservative ideals still currently jeopardizing women's health issues in the medical profession. IUDs are supposedly not recommended for women who have not yet given birth (like me). I suspect that this is partly because "they" believe you should have babies, and if you pop in an IUD before you pop out a baby, you just might addict yourself to the amazing amazement of childless sexuality. And as long as you're enjoying a radical sex life, you are probably much too content to go shopping very often, and your urge to consume commercial goods and services is effectively replaced by your urge to merge. Why would I need to buy a new iPhone or Juicy pants when I can just go home and hop in bed with my man? I don't really know. But I'm always on the lookout for the ways those J-C ideals are trying to mess up everybody's sex life. The decision to insert an IUD is ultimately your choice but does depend partly on the size and shape of your uterus. Your gynecologist can determine this during your next visit.
Something I didn't know until the week I decided to go ahead with the thing: IUD insertion is best facilitated during menstruation. I think this has something to do with your ute being more loose and floppy, and lower to the ground (maybe?). And so, on a fateful, menstrual, August morning, I woke up early and asked my gentleman friend if he would drive me to the doctor's office. He of course felt silly for not offering in the first place, and we both had no idea how greatly we would later appreciate the mutuality of the excursion.
I spent about 15 minutes on the table, but the actual insertion took about 30 seconds. It was a bit painful, in the way that the Pap scraping can be painful. The cervix and uterus cramp a little when touched by a mean device. I winced, and said "Oh, shit." And then it was over. My lady parts felt a little sore, still. The ute was indeed displeased. But I rubbed my back and massaged my hip bones for a minute and felt ready to go. I was stoked. Just fifteen minutes for me to claim a small victory over nature.
I waltzed triumphantly out into the waiting room, threw open the door, and cried out, "Ah ha ha ha haaaaaaa, take that, nature!" This, I later learned, alarmed some of the people in the waiting room, who had just been talking about witchcraft and the commonality of witches in the general population. I, witch or not, with a man on my arm and a little Mirena in my nether-pocket, strolled gleefully out of the office.
CHAPTER FOUR. WRATH.
When we reached the parking structure, my uterus announced in no uncertain terms that it was FUCKIN PISSED. The suddenly severe cramping rendered me nearly unable to walk, and I certainly would not have been able to drive. It was a pain unlike any before. I tried to keep a stiff upper lip but gave myself away when the gentleman cracked a joke and I let out a forced laugh. It was a hopeful laugh, I'd say. I wanted to laugh, but try as I might, I could not think about anything. And I tried to think about reaching over to the driver's seat and pulling someone's balls right out of their sack, but I could only wince and writhe in pain. It was the worst I had experienced, and it continued to worsen over the course of the next three hours.
At home, frantically walking around the house trying not to cry out like a banshee, I inadvertently leaned up against the warm dryer (or was it the oven?) and discovered that heat relieved the sensation of pain. I thought a hot shower might help. It did, but in the shower the pain overwhelmed me and I nearly passed out (no exaggerating, here). For a few minutes, I sat in the shower, whimpering and faint, unable to move. But then I had to move because I felt the vomit rising in my throat. I flew out of the shower and heaved over the toilet for a minute, but nothing came. Oh, illusory vomit, joy of female reproductivity. This sensation was short-lived, thankfully. With conditioner still in my hair, I retreated to bed, where I whined and grasped my lower abdomen, with conflicting desires to tear out the IUD, tear out my entire female reproductive mass, or tear out the guts of my gentleman friend and smear his entrails over the walls and my face. This was due to no fault of his own except that he was the person most proximal to me who was not in pain.
The gentleman was a very attentive, sympathetic nurse, which was especially remarkable (and dearly appreciated) considering that he had not planned on treating an invalid all day, and in fact was quite busy working on a vaudeville routine, or something like that, and preparing for a playdate with a pair of bisexual 21-year-old girls (not part of the vaudeville act) later that evening--completely platonic, of course. Whatever the case, my tightly-wound uterus and I didn't especially want to hear about it at the time, but as I have learned in my old age, some things are best forgotten as soon as they are learned. And my then current pain was rendering my entire future a completely blank slate. The fact of my relationship to this man/boy/shit/dog (I didn't care) paled in significance to the capacity of my body to experience physical sensations. I didn't care if either one of us lived or died. This pain was LOUD in there. It was a pain that made me question my feelings for the young gentleman who would enjoy benefits of my pain, without enduring so much as a knick of pain himself. And WOULD he endure such pain, for our sake, if the necessity arose? I wondered.
And I doubted. Surely not, I thought -- this coward. This pathetic, leg-humping puppy. This thoughtless, unrestrained dick-brain. This selfish, ball-less, stupid little boy! How dare he kiss my cheek as if it were deservedly his?!?! How dare he have a phone conversation with another female, in front of me?! How can he sit there, callously checking his email and flight information?! What NERVE he has, WORKING ON HIS OWN PROJECTS IN THE LIVING ROOM!! HOW DOES HE GET OFF GOING ABOUT HIS OWN BUSINESS WHILE I'M OBVIOUSLY NAPPING IN PAIN?!?!?!!? THAT WHORE-MONGER! MISOGYNIST! FUCKSTAIN!
Such were the thoughts of my pained brain.
And then I thought about how different the daily thoughts must be for people who live with some degree of pervasive pain, whether physical or emotional, and however subtle.
If you are indeed considering IUD use, I highly recommend, in preparation for the possibility of intense pain, fainting, and nausea, that you secure a completely loving, devotedly attentive nurse, who will drive you to and from your insertion appointment, and who will later bring you hot compresses and pain pills, and perhaps even play you a little tune on the piano, and will act as though you are the most beautiful creature fathomable. I was lucky enough to have the very same.
The pain gradually improved. Very gradually. I was in bed for 3 days, popping ibuprofen, or whatever, and trying to sleep. After a week, I was no longer in any pain.
Also after a week, I was still bleeding. I got the IUD inserted at the tail end of my period, and my bleeding remained at a constant level for about 3 weeks. Then it increased, as if it were a period, kinda, and with severe cramping (not as bad as the post-insertion pain, however). This 'period' was heavy and lasted for a full week. The bleeding subsided, but remained at a light level. Not as light as 'spotting.' Bleeding irregularities are completely normal with IUD use, especially during the first 3-6 months. My strange cycle continued throughout the two months following insertion. During those two months, I had three periods of heavier bleeding, and the rest of the time my flow was light but heavy enough to require a pad or tampon. This was not the most convenient thing, but it was certainly not the most inconvenient.
CHAPTER FIVE. PRIDE.
I should have expected that shoving a twisty piece of plastic into my uterus would cause some degree of upheaval. The cramping is normal, and had I done just a little more research, I could have been more prepared for it. I was not prepared for the increasingly pungent scent which began to crawl out of my nethers, about 1 month following insertion. I recognized the scent as one that underlies my normal menstrual blood to a usually indetectable degree. But my normal menstrual blood is thick and dead-like after hanging around in the ute for a while. You know how it is. Now, however, from the wrath of my thwarted uterus, the blood was constant, thin, fresh, and ripe, and the raw scent was magnified, TIMES A BILLION. I called my friend B. to ask if she too had experienced her coot smelling like a death camp. She said no.
I became extremely conscious of this scent. I believed I could smell it all the time, everywhere. I was sure other people could smell it, too, and must wonder when I last showered. It was so bad, it distracted me from sex, which I could not enjoy. (I'll get back to the sex part later.) The experience of being repulsed by my own scent was incredibly disheartening. I felt unattractive, sexless, and gross. I thought it must be equally displeasing to my bed mate, and I felt certain he would be soon distracted by all of those other sweet, delicious private smells wafting by him on the street. My own was a cave of fresh roadkill. When we were in bed, as soon as I caught wind of it, I would feel certain that he, too, was wishing his nose would leap off and was only feigning ignorance so as to not hurt my feelings. It was unpleasant for both of us, but of course much more so for me. Oral sex was mutually ruled out for a brief time, but my dearest kindly pacified me with regular old coitus, for a while. The wicked scent was not merely fuckin disgusting; it caused a radical change in my sexual response. Intercourse became painful, and at the time, I did not know why. I had to call a temporary halt to all genital explorations while I dealt with the shit. I later realized that because I could not get my mind off the scent, I could not become aroused normally, so my body and lady parts did not go through all their normal changes in tension, swelling, and wetness. And not being able to enjoy sex made me significantly less able to enjoy anything at all.
I worried that the smell and its side effects were a semi-permanent change concurrent with IUD use. I fretted and was sad. The gentleman was extremely kind, affectionate, optimistic, and had developed a case of allergies so severe he could not smell anything, so we decided to wait a couple weeks before visiting the doctor or thinking drastically. After those few weeks, over the course of one, the smell exited, and the scent of my sweet sweet self returned. I believe the scent could have resulted from the new consistency of blood, or from the readjustment of my vaginal bacterial zoo, acclimating to the new local hormones from the IUD. In any case, I am proud to have a wet and fortitudinous vagina. I never imagined the smell of my own genital secretions could make me so so sad, or so ecstatically happy.
CHAPTER SIX. ENVY.
The scent was gone, and the flow began to wane. I held on to hope for a wet but bloodless future. Bloodlessness is also a common effect of the IUD, and one I was very excited about. Ever since I first learned about periods in 4th grade, I thought the monthly arrangement was totally fucked. I remember telling my 4th grade teacher, "I don't need to see the nurse's video because I'm not going to start my period, ever."
"Don't be silly," she said. "It's time for you to grow up."
"No. I won't," I announced. And I meant never.
I don't take my fertility for granted. I am very VERY lucky that its employment is currently optional. And someday when I am independently wealthy or when childbearing won't enslave me to a repressive socio-political environment, or when I move out of the country, I might like to take advantage of the breadth of biological experience available to me. But for now, I will enjoy the ravages of twenty-something-hood as an equally significant biological adventure.
Exactly three months after IUD insertion, the bleeding stopped. And after one week, it was still gone. In celebration, I baked a cake: red velvet, with white frosting.
Yay, right? Yes. Yes. Yes yes yes. YES. YES. Ohhh, yes.
CHAPTER SEVEN. GLUTTONY.
Speaking of sex... spontaneity makes a difference, naturally. Sure, I put up with three months of cramps, blood, and death scents, and I ruined nearly all the panties I own, plus three sets of sheets belonging to my gentleman friend, BUT I don't have to think about it anymore. No daily pill or monthly ring to remember. No condom or diaphragm to fuss with. Just a boy and a girl oozing pheromones and imagination: poolside at the Renaissance hotel; an enclosed booth at Luna Park Kitchen; the backseat of a taxi in Denver CO; the bathroom at Pea Soup Andersen's off highway 101. I'll let you guess which one of those we've already crossed off the list. Let freedom ring.
Those first three months were downright sick, but they were a small price to pay for what could be FIVE YEARS of easy, painless, forgettable birth control. For now, I'm cruisin. That little plastic T is floating comfortably in the small space of my virgin uterus, like a piece of secret tribal jewelry, reserved for my spiritual meetings with the shaman in the tent of smoke and steam. ...or something like that.
Of course, with all this pleasure I'm reaping from MEDICAL TECHNOLOGY, it becomes increasingly difficult to consider myself a Neo-Luddite.
(In the words of the Sherman Brothers...)
There's a great, big, beautiful tomorrow
Shining at the end of every day
There's a great, big, beautiful tomorrow
And tomorrow's just a dream away
A [woman] has a dream, and that's the start
She follows her dream with mind and heart
And when it becomes a reality
It's a dream come true for you and me
So there's a great, big, beautiful tomorrow
Shining at the end of every day
There's a great, big, beautiful tomorrow
Just a dream away...
P.S. I am _not_ a doctor or health professional. I'm just a lady who knows a thing or two about sexual health and my own body. In my own research on the IUD, in 2007, I was surprised to find few (zero) detailed accounts of user experience, and when I was reeling in the havoc of a pissed-off corpse-scented crotch-hole, I sure wished I had more stories from the sisterhood to let me know my experience was normal. One thing I know for sure about the effects of IUD insertion is that they vary greatly, and that users must pay close attention to their bodies in the few months following insertion, due to the potential seriousness of possible side effects.
If you found this page in a search results list and are reading this because you are considering IUD use, please share a comment and let me know if the information presented was helpful or how it could be improved. Please, read on for further information: Mirena patient product information and what to expect. If you want to read former comments to this post, from the Scrubbed Innocence blog, visit scrubbedinnocence.blogspot.com.
Thanks to KrissyKristan for giving me many fine examples of excellent blogness, and to M-Soul for trying to teach me things about technology. Thanks to P. for agreeing to seduce a strawberry in the produce section.
AFTER 18 MONTHS WITH THE MIRENA I.U.D.
The short story is, I'm in love. My I.U.D. and me have, for the most part, been true blue to each other.
In month 3, I went in for a follow-up check, as suggested, and also because we couldn't find the string. Turns out the doc had cut it a little short, so it wiggled itself up into the ute pretty good. Not to worry, according to the new doc. This does not affect removal, as they have to dilate you a bit anyway.
For those of you just dying to know, the crotch-stink never came back. I think it was from the ripe, fresh blood that drained out of me continuously for about 5 weeks following insertion. Something new to appreciate: not bleeding!
And about bleeding, my periods have become significantly less and less bloody over the months. This is fabulous. With the money I have saved by not buying tampons, I have been able to buy a home in Malibu!
That was a joke. I've probably just used it to buy more lipstick, nailpolish, lubricant, and other things shaped like tampons.
Another thing I really appreciate about the IUD is that, after the fourth month or so, my vaginal wetness was gushing along as usual. A real downside of the pill, for me, was a little drying up of the creek... but that may have also been due to that old boyfriend who couldn't learn the value of foreplay, now that I think of it. So, thanks to both the IUD and my equally easy and (mostly) painless man-friend, for keeping the good times gushing.
And finally, thanks to all who have read and shared this blog entry. Please continue to pass the knowledge on to your female compatriates. And please, those of you who leave comments, let me know where you're from, and if you are affiliated with the medical profession or discussion forums. I like to know where Scrubbed Innocence flows!