Wednesday, 18 January 2017

Why I Removed My Mirena and Went Hormone-Free

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Ideologically, I've never liked the thought of putting extraneous hormones into my body.

Practically, though, it made sense.

The hormonal tweaks we put ourselves through in the name of birth control are portrayed by our cultural contexts and peers as utterly normal -- to be expected, really. It's irresponsible not to -- right? And I see why. Often, it's not sustainable for long-term couples to continue using barrier methods, especially if one of them is allergic to latex and needs more expensive alternatives. Assuming both partners are monogamous and have been tested for STI's, using barrier-free hormonal birth control seems to be the most logical step to facilitate spontaneity within a relationship. For some reason, I also get the sense (within my friend group and from medical professionals) that hormonal BC is conceptualised as more effective than condoms.

Why? We're all taught that condoms are 98% effective. What makes the pill (the number-one choice amongst young uterus-having people) the preferred method?

Real life vs theory

Turns out that nearly all BC methods have differing use effectiveness and theoretical effectiveness rates. Theoretical effectiveness is often what we learn about in school -- it's the calculated result of tests within a lab/study environment. Use effectiveness, however, is what actually happens in real life, when you're in a rush and accidentally scrape a condom with your nails while opening it, or get food poisoning and throw up the pill you just took. The variables within everyday existence decrease the overall efficacy of your birth control method. And sometimes, it might even be out of your control. Everyone has heard some horror story where a person got pregnant while using both condoms and the pill, or the contraceptive injection they were administered was expired and thus no longer effective. It seems that there are always sneaky external factors that affect one's potential fertility despite how responsible you try to be.

As it turns out, the pill actually is more effective than condoms, even in real life. While penile condoms have 82% efficacy with typical use (and vaginal versions are billed at 79%), the pill is still right up there with a 91%  chance of it actually doing its job. Sounds like a much better deal. If you're open to casual hook-ups it can be a relief to know that you have a hormonal backup preventing unwanted pregnancy, even if you use condoms to limit STI's.

For me, I started the pill for the reason many teens do: I was having crippling period pain. Many of my friends had started the (progesterone only) minipill to smooth their blemished skin or allow them to actually function like normal human beings, so taking a contraceptive pill every day seemed far more logical than taking a painkiller every time I felt sore.

Because societal norms, right?

Eventually, I switched to a combined oestrogen-progesterone version because it was offered for free at the university clinic. I didn't notice a difference, but my body did. I developed melasma, a condition in which you develop darker pigmented patches on your face. It's also known as "pregnancy mask."

Yeah. I got pregnancy skin. This seemed indicative of a problem. So I stopped the pill and went hormone free for years (with no consequence, because penetrative sex was not a thing). When I started worrying about pregnancy again, I got the Mirena as it's 99% effective no matter what.

It was possibly the worst hormonal decision I could have made.

How the Mirena made me fat and ruined my life

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The Mirena was awesome. I recommended it to everyone. "It's an investment!" I would wheedle convincingly. "You just get it done and it's good for five years! And you'll never forget to take a pill or carry a condom! It's fantastic!"

I kept recommending it as I got fatter. I upped my exercise, and kept recommending it as I got fatter. I tightened up on my diet, and got fatter. So I got a personal trainer. The numbers on the scale crept steadily upwards as I told everyone how great my Mirena was, spending my free time reading books on nutrition and trying new forms of meal plans as I worked out at home and in the gym and at group-fitness HIIT. I collected golfball-sized clumps of hair in the shower, and swept further fluffy dust-mounds from the corners of my house. I wondered why I would get pins and needles from thirty seconds of normal sitting, but dismissed it as normal.

I had my Mirena for three years before I found out that there are multiple online forums filled with women complaining about how the Mirena made them fat or dangerously sick. Interestingly, many of the symptoms these people experienced were not side-effects listed on 'legitimate' websites, and when I spoke to medical professionals about my concerns they seemed to think I was overreacting after spending too much time reading unverified scare-tactics on the internet. Nevertheless, I believed these faceless internet people, because they were talking about real, lived experiences, not controlled medical tests.

I spoke to three different medical professionals about my concerns, and they all seemed very worried about what I would use if not hormones. "Barriers, I guess," I responded. "But that's if I have PiV sex. I don't want to, so I don't see it as a big factor. I'm also tracking my fertility just in case, so I can combine barriers with the rhythm method. If I ever have penetrative sex."

The three female doctors I saw sighed and kept respectfully silent. They believed in the near-failsafe nature of hormonal birth control, and thought I was making a bad decision. I, however, rejoiced as my issues with weight, painfully numb extremities and excessive hair loss became a thing of the past.

I don't think I'll do the hormonal BC thing again.


Thola Antamu writes about her reasons for going hormone-free here, as well as her experience with the rhythm method. Check it out!

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