Teen needs help considering birth control options

[Sneezyone]

1 minute ago, Condessa said:

Maybe because it’s newer, so not all OBs do them?  My regular OB has never done the arm implant, after talking over all the options and my past experiences she recommended it to me, but then had to refer me to someone else to get it.

It’s not new. My 13yo friend got it after giving birth decades ago. We’re in our mid 40s for context.

[Condessa]

Just now, Sneezyone said:

It’s not new. My 13yo friend got it after giving birth decades ago. We’re in our mid 40s for context.

Oh, silly me.  I just assumed it was newer because I never heard of it before five years ago.  I wonder why no OB ever mentioned it to me when I was younger and looking for better options?

[Sneezyone]

Just now, Condessa said:

Oh, silly me.  I just assumed it was newer because I never heard of it before five years ago.  I wonder why no OB ever mentioned it to me when I was younger and looking for better options?

Honestly, I think a lot of docs don’t keep up with research and trends. Reproductive medicine and women’s health care is every bit a specialty. Even gynos don’t keep up, some are even philosophically opposed to hormonal methods. Seriously and truthfully, this is why I sent DD to PP for this kind of care. They gave her all the options, without judgment or prodding/prompting, and let her decide.

[wathe]

https://www.sexandu.ca/wp-content/uploads/2021/05/SOGC_14372_Contraception_DownloadablePDF_ENG_WEB.pdf

Link to Society of Obstetricians and Gynaecologists of Canada contraception booklet, that has details for every method going.  Their https://www.sexandu.ca/ is comprehensive.

Other options besides pills, implants and IUD's, include patches and vaginal rings - both non-invasive, and require less remembering than a daily pill.

I love my Mirena.  Insertion was a bit pinchy but not terrible.  Insertion under sedation or anesthesia is an option here.  Not having periods is very freeing.

 

[Corraleno]

The medical practice that DD and I go to is quite large (at least a dozen doctors plus 3 or 4 NP/PAs), and when DD requested the implant she was told that only one doc in the practice does them, so she had to book an appointment with that person instead of her regular doc.

Planned Parenthood does them all the time, but at least in our area PP does not take insurance, so it would be ~$700-800 out of pocket, whereas it was totally free with our insurance, which covers 100% of contraceptive costs.

[KungFuPanda]

3 hours ago, SKL said:

This was an OB-GYN office, so one hopes they know how to do these relatively routine things.  2 professionals talked to us, I assume the OB-GYN MD and a nurse in the practice.

They didn't bring up anything other than the Pill.  After it felt like we were about to be sent out with a prescription and no mention of other methods, I asked about IUDs.  I did not ask about other methods, and they didn't bring them up.

It could be because my kid is 16 and has no past history with sex or birth control.  Maybe their idea is to start out with the least invasive option.  Going in, I expected them to cover at least the basic range of popular options.  Silly me.  😛

At the moment I'm leaning toward the Mirena IUD.  I prefer something that will last well into my kid's higher education journey / early career.  I won't force it if my kid is too scared of the procedure.  She might actually prefer the arm implant.  She asked me about that, but silly me assumed the OB-GYN would have brought it up if it was a comparably safe, effective method.  Maybe we could discuss it on a call, now that she's an established patient.

They might start with the pill because if your daughter doesn’t tolerate the hormones it’s less invasive to stop taking it than to have something inserted, then removed, from her body. 

[Sneezyone]

1 hour ago, Corraleno said:

The medical practice that DD and I go to is quite large (at least a dozen doctors plus 3 or 4 NP/PAs), and when DD requested the implant she was told that only one doc in the practice does them, so she had to book an appointment with that person instead of her regular doc.

Planned Parenthood does them all the time, but at least in our area PP does not take insurance, so it would be ~$700-800 out of pocket, whereas it was totally free with our insurance, which covers 100% of contraceptive costs.

Yikes!! Here they don’t take private insurance either but will accept Medicaid. DDs Mirena was $300. Very affordable for us.

[LucyStoner]

I had side effects from the pill and Mirena.  The side effects of the pill weren’t insubstantial for me- mood changes, loss of libido and weight gain.  Her mileage almost certainly will vary (I don’t think most women experience the degree of side effects I did with birth control but it’s far from unheard of either) but I frankly found that the side effects of birth control were very much minimized by my doctors when I asked about them.  After my first son was born, we used fertility awareness and barrier methods because I wasn’t willing to tolerate the side effects anymore.  

Some of the young women I know have had good experiences with the implant.  I would probably look at that over an IUD if it’s important to her to be on something before she’s sexually active.  

[kbutton]

11 hours ago, mommyoffive said:

I am having a migraine right now, so my thoughts might not be super clear. 

Do you have any more info on this?  Would just having the natural estrogen in your body and then be a person who has migraines put you at more risk for blood clots?  Or if you were on the pill decades ago, but then develop migraines?

Migraines are associated with blood clots and stroke, IIRC. I don’t know what risks natural estrogen conveys. I don’t think past use of the pill increases risks, but I don’t know for sure.

[heartlikealion]

I actually need to evaluate options for myself at an upcoming appt. I don’t know if the shots were considered? Or those patches? While married we relied heavily on fertility charting (I took classes and did follow ups with my teacher but many times I was not confident in my observations/chart). 

I just wanted to mention concern for an IUD or other item (like nuva ring) coming out unexpectedly. Though probably rare I have heard of this. I think the Mirena came out in an episode of the reality show Teen Mom. Google Chelsea). 

[ktgrok]

21 hours ago, Sneezyone said:

 

My personal feeling is that any teen contemplating sexual relationships should be comfortable with the idea of getting an IUD and having vaginal exams performed. If that’s a bridge too far for the patient, they should be reconsidering their relationship.

Having medical care, sure. But I don't see the correlation between having a foreign object put in your uterus with having sex. Lots of adult women with families are not comfortable with an IUD. it has nothing to do with maturity or readiness for sex. 

18 hours ago, wathe said:

https://www.sexandu.ca/wp-content/uploads/2021/05/SOGC_14372_Contraception_DownloadablePDF_ENG_WEB.pdf

Link to Society of Obstetricians and Gynaecologists of Canada contraception booklet, that has details for every method going.  Their https://www.sexandu.ca/ is comprehensive.

Other options besides pills, implants and IUD's, include patches and vaginal rings - both non-invasive, and require less remembering than a daily pill.

I love my Mirena.  Insertion was a bit pinchy but not terrible.  Insertion under sedation or anesthesia is an option here.  Not having periods is very freeing.

 

Oh, I forgot about the ring! I used that for years - it is probably my favorite method but it is less effective over a certain weight. And I did get some nausea the first day or so of a new ring, each month. But tolerable and nothing to forget!

16 hours ago, KungFuPanda said:

They might start with the pill because if your daughter doesn’t tolerate the hormones it’s less invasive to stop taking it than to have something inserted, then removed, from her body. 

This. 

 

[mommyoffive]

9 hours ago, kbutton said:

Migraines are associated with blood clots and stroke, IIRC. I don’t know what risks natural estrogen conveys. I don’t think past use of the pill increases risks, but I don’t know for sure.

I did not know this.  Thank you for posting about it.  Although as a migraine sufferer it worries me.  Is there anything someone who gets migraines can do to lessen the risk of blood clots and stroke?  Other than just knowing the signs of them?

[kbutton]

2 hours ago, mommyoffive said:

I did not know this.  Thank you for posting about it.  Although as a migraine sufferer it worries me.  Is there anything someone who gets migraines can do to lessen the risk of blood clots and stroke?  Other than just knowing the signs of them?

I have no idea, honestly. I take a buffered baby aspirin daily because there is such a huge clotting history in my family. No doctor told me to, but after hearing my history, none tell me not to! Only some of the people with clots have had genetic testing, and the two people who have a solid or semi-solid answer about theirs have an autoimmune cause that clusters in families but is not known to be directly inherited. 

[wathe]

Regarding migraine with aura and estrogen containing contraceptives and stoke:

The state of the evidence is not strong.   We know that women who have migraine with aura alone are at increased risk of stroke (small but real).  We know that OCP alone increased the risk of thromobosis and ischemic stroke (small but real).  It is not clear that OCP + migraine with aura increases the risk in combination any more that each would increase the risk alone.  Migraine without aura does not seem to be correlated with stroke risk at all. OCP decreases lots of other risks - all cause mortality is lower for women who've used OCP than for women who haven't - so it's important to consider all risk and benefits specific to each user.   

Combined hormonal contraceptives and migraine: An update on the evidence plain language paper

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662520/ technical paper

UpToDate recommendation (paywalled, but links to references are not):  Patients experiencing migraine withoutaura (MO) can safely use estrogen-containing contraceptives, including oral pills, transdermal patches, and vaginal rings. Individuals with migraines with aura (MA) are generally not candidates for estrogen-containing contraceptives [17-19]. However, the absolute risk of stroke in women with MA on combined hormonal contraceptives (CHC) is small, and good quality studies specific to low-dose estrogen products are lacking [20]. Therefore, the use of CHCs in women with MA should be individualized. For those with a clear indication for CHCs, such as endometriosis or those who desire this method after a clear discussion of the risks, their use is reasonable.

I am a person who has infrequent migraine with aura.  I was on the pill for about 15 years as a teen and young woman.  The overall risk/benefit balance worked out in favour of the pill for me (and, of course, the state of the evidence was different then, in the 80's and 90's)

Edited February 18, 2023 by wathe

[PronghornD]

I don't need birth control anymore, but I am curious. When they say "migraine with aura" does that include people for whom the only migraine symptom is aura. I've never had the headache or any other symptoms. But if I eat a triggering food, I sometimes experience the aura.

[Sneezyone]

10 hours ago, ktgrok said:

Having medical care, sure. But I don't see the correlation between having a foreign object put in your uterus with having sex. Lots of adult women with families are not comfortable with an IUD. it has nothing to do with maturity or readiness for sex. 

A p*nis is a foreign object. A tampon is a foreign object. An IUD is a foreign object. If my kids are going to engage in behaviors that place foreign objects in the v*gina (which is how IUDs are inserted), I insist that they be comfortable discussing what that process entails and how insuring ongoing sexual and reproductive health requires regular examinations of the area. I don't care whether the IUD is the BC method of choice. I have no patience for missish-ness if you're engaging in or contemplating sex.

Edited February 19, 2023 by Sneezyone

[bolt.]

50 minutes ago, Sneezyone said:

A p*nis is a foreign object. A tampon is a foreign object. An IUD is a foreign object. If my kids are going to engage in behaviors that place foreign objects in the v*gina (which is how IUDs are inserted), I insist that they be comfortable discussing what that process entails and how insuring ongoing sexual and reproductive health requires regular examinations of the area. I don't care whether the IUD is the BC method of choice. I have no patience for missish-ness if you're engaging in or contemplating sex.

I fail to see how your personal level of "patience" with someone has anything to do with their personal preferences and boundaries around IUD insertion.

An IUD insertion is not a sexual act, and has nothing to do with sexual activity.

People need sexual healthcare whether they are sexually active or not. Female bodied people require occasional pap smears, but not "regular examinations" of their vulva, vagina, or uterus. And they require pap smears whether they are sexually active or not. A person with an IUD will require a yearly string check whether they are sexually active or not -- and the doctor informs the patient about the need for the string check, whether or not the patient's parent has gone over that in advance. And I think a string check is barely an 'examination' and hardly worth using that word.

So, I'm really not seeing the connections you are making whatsoever. It's like you are trying to connect the need for regular dental care with a person's level of readiness for kissing.

I don't know what you mean by "missish-ness" (might be an expression that is local to you, but not to me) but it's just coming across really strangely. And judgementally.

People who have sex need to understand about sex. People who have IUDs need to understand about IUDs. Just because they are in the same locality does not mean that comfort with one thing is automatically equivalent to comfort with another thing. Both are very personal decisions, and I don't think it makes sense to be judgmental about someone just because their decision about the one thing is does not (in your eyes) align with their decision about the other thing.

[Sneezyone]

Just now, bolt. said:

I fail to see how your personal level of "patience" with someone has anything to do with their personal preferences and boundaries around IUD insertion.

An IUD insertion is not a sexual act, and has nothing to do with sexual activity.

People need sexual healthcare whether they are sexually active or not. Female bodied people require occasional pap smears, but not "regular examinations" of their vulva, vagina, or uterus. And they require pap smears whether they are sexually active or not. A person with an IUD will require a yearly string check whether they are sexually active or not -- and the doctor informs the patient about the need for the string check, whether or not the patient's parent has gone over that in advance. And I think a string check is barely an 'examination' and hardly worth using that word.

So, I'm really not seeing the connections you are making whatsoever. It's like you are trying to connect the need for regular dental care with a person's level of readiness for kissing.

I don't know what you mean by "missish-ness" (might be an expression that is local to you, but not to me) but it's just coming across really strangely. And judgementally.

People who have sex need to understand about sex. People who have IUDs need to understand about IUDs. Just because they are in the same locality does not mean that comfort with one thing is automatically equivalent to comfort with another thing. Both are very personal decisions, and I don't think it makes sense to be judgmental about someone just because their decision about the one thing is does not (in your eyes) align with their decision about the other thing.

I was referring to my kids and those in my counsel. What others do and how they approach matters is their business. What I'm talking about is SQUEAMISHNESS not physical discomfort. And, yeah, seriously, if you can't handle a dentist checking your gums for disease you shouldn't be kissing either, JMO. 

[ktgrok]

1 hour ago, Sneezyone said:

A p*nis is a foreign object. A tampon is a foreign object. An IUD is a foreign object. If my kids are going to engage in behaviors that place foreign objects in the v*gina (which is how IUDs are inserted), I insist that they be comfortable discussing what that process entails and how insuring ongoing sexual and reproductive health requires regular examinations of the area. I don't care whether the IUD is the BC method of choice. I have no patience for missish-ness if you're engaging in or contemplating sex.

Sure, and I agreed that medical care and such are vital, and if not ready for that, not ready for sex. But an IUD goes not just in the vagina, but the uterus. As I said in this thread, I've had one. I know how they are put in. But having a foriegn object left in your uterus, and forced through your cervix, is VERY different than having sex. VERY different. Being okay with one does not = being okay with the other. (and my IUD placement took 3 tries, two different providers, and then two visits to remove as I ended up needing a cystoscopy to go looking for the IUD becuause it had turned sideways and partially embedded in my uterus. The poor student observing was freaking out when he said it come out with a chunk of my uterus stuck to it. 

So yeah, no sex I've ever had, nor any tampon, has taken multiple people to make it happen and only then with an anesthetic injected into my cervix, and then ripped out a chunk of my uterus. 

[ktgrok]

1 minute ago, Sneezyone said:

I was referring to my kids and those in my counsel. What others do and how they approach matters is their business. What I'm talking about is SQUEAMISHNESS not physical discomfort. And, yeah, seriously, if you can't handle a dentist checking your gums for disease you shouldn't be kissing either, JMO. 

Concerns about an object being forced through your cervix (which is meant to keep things out) and then left in your uterus is not "squeamishness". 

[Sneezyone]

Just now, ktgrok said:

Sure, and I agreed that medical care and such are vital, and if not ready for that, not ready for sex. But an IUD goes not just in the vagina, but the uterus. As I said in this thread, I've had one. I know how they are put in. But having a foriegn object left in your uterus, and forced through your cervix, is VERY different than having sex. VERY different. Being okay with one does not = being okay with the other. (and my IUD placement took 3 tries, two different providers, and then two visits to remove as I ended up needing a cystoscopy to go looking for the IUD becuause it had turned sideways and partially embedded in my uterus. The poor student observing was freaking out when he said it come out with a chunk of my uterus stuck to it. 

So yeah, no sex I've ever had, nor any tampon, has taken multiple people to make it happen and only then with an anesthetic injected into my cervix, and then ripped out a chunk of my uterus. 

AGAIN - BEING COMFORTABLE WITH THE IDEA AND THE DISCUSSION IS NOT FORCING AN ALTERNATIVE ON ANYONE. It's about recognizing the act itself, and the products of conception can also be sources of pain and discomfort. 

[Sneezyone]

Just now, ktgrok said:

Concerns about an object being forced through your cervix (which is meant to keep things out) and then left in your uterus is not "squeamishness". 

Yes, it is. Cause when things go in your cervix and result in conception they also must come OUT.

[ktgrok]

Just now, Sneezyone said:

Yes, it is. Cause when things go in your cervix and result in conception they also must come OUT.

Yes, but there is a process where your body takes the time to soften and dilate and efface the cervix before that thing comes out. Also, that process is PAINFUl, as is IUD implantation. There are many other birth control options that prevent the need for something to come out, while also not forcing something IN. 

[Sneezyone]

1 minute ago, ktgrok said:

Yes, but there is a process where your body takes the time to soften and dilate and efface the cervix before that thing comes out. Also, that process is PAINFUl, as is IUD implantation. There are many other birth control options that prevent the need for something to come out, while also not forcing something IN. 

Just as your experience with the IUD was traumatic, so was mine with birth. The IUD was a cake walk for DD in comparison. So, no, I don't share your view that being uncomfy with discomfort is a good, fact-based way to approach the reality of repro-healthcare and childbearing (for those who choose to give birth).

Edited February 19, 2023 by Sneezyone

[ktgrok]

2 minutes ago, Sneezyone said:

AGAIN - BEING COMFORTABLE WITH THE IDEA AND THE DISCUSSION IS NOT FORCING AN ALTERNATIVE ON ANYONE. It's about recognizing the act itself, and the products of conception can also be sources of pain and discomfort. 

The act itself causes pain and discomfort akin to childbirth or IUD placement????? It certainly shouldn't. 

Now, if you meant the person shouldn't be squeamish just talking about birth control, sure, I agree. But if you mean that not wanting an IUD because it is invasive and painful is just squeamishness, we do not agree. 

[ktgrok]

1 minute ago, Sneezyone said:

Just as your experience with the IUD was traumatic, so was mine with birth. The IUD was a cake walk for DD in comparison. So, no, I don't share your view that being uncomfy with discomfort is a good, fact-based way to approach the reality of repro-healthcare and childbearing (for those who choose to give birth).

One of my births was traumatic enough to leave me with PTSD. So I get that birth can be traumatic. BUT...I wouldn't say that made me squeamish either. 

[Sneezyone]

Just now, ktgrok said:

The act itself causes pain and discomfort akin to childbirth or IUD placement????? It certainly shouldn't. 

Now, if you meant the person shouldn't be squeamish just talking about birth control, sure, I agree. But if you mean that not wanting an IUD because it is invasive and painful is just squeamishness, we do not agree. 

Ma'am, if you're just trying to be argumentative, say so. There are plenty of women here on this site who've said many times that they find the act painful. That, too, is a potential reality.

[heartlikealion]

I think some of the analogies are reaching. I hate things touching my eyes. Some people hate going to the dentist. Neither have anything to do with intimacy. 

My first ob/gyn visit was a bit traumatic. My mom wouldn’t let me go earlier when I inquired because I wasn’t sexually active. Then shortly after becoming sexually active I got pregnant and my first appt was to confirm the pregnancy and get an internal ultrasound uggghhh. Yeah that wand. 

[ktgrok]

Just now, Sneezyone said:

Ma'am, if you're just trying to be argumentative, say so. There are plenty of women here on this site who've said many times that they find the act painful. That, too, is a potential reality.

It can be, and is a sign that something is wrong, not something to be accepted. 

The idea that well, birth is painful and can be traumatic, and so it sex, so birth control might as well be too is just not an idea I can grasp. And I DID get an IUD. I decided the pain was worth it, for me. But I'd never consider someone squeamish because they chose a less painful option, or didn't want a foreign object left in their uterus, or were concerned about uterine perforation. 

[Sneezyone]

Just now, ktgrok said:

It can be, and is a sign that something is wrong, not something to be accepted. 

The idea that well, birth is painful and can be traumatic, and so it sex, so birth control might as well be too is just not an idea I can grasp. And I DID get an IUD. I decided the pain was worth it, for me. But I'd never consider someone squeamish because they chose a less painful option, or didn't want a foreign object left in their uterus, or were concerned about uterine perforation. 

Since none of what you wrote is what I said, I'm going to respectfully bow out now. Have a nice evening.

[Sneezyone]

3 minutes ago, heartlikealion said:

I think some of the analogies are reaching. I hate things touching my eyes. Some people hate going to the dentist. Neither have anything to do with intimacy. 

My first ob/gyn visit was a bit traumatic. My mom wouldn’t let me go earlier when I inquired because I wasn’t sexually active. Then shortly after becoming sexually active I got pregnant and my first appt was to confirm the pregnancy and get an internal ultrasound uggghhh. Yeah that wand. 

Meh - I don't let my kids not go to the eye doctor and get their eyes checked b/c they don't like the sensations. I hate the dentist and have lots of trauma behind it but I do it anyway because I would rather have my teeth than dentures. DS won't wear contacts. DD took three trips before managing. They still get annual eye exams because it's part of ensuring their health. These things have to be talked about, managed, and on you go. I, too, have many friends and acquaintances who were never allowed to use tampons and never had a sexual health exam but ended up teen parents behind actual sexual activity. That's cray. If you're grown enough to need an exam to see properly, keep your teeth, or engage in sex, it's my job to prepare you for it.

[heartlikealion]

1 minute ago, Sneezyone said:

Meh - I don't let my kids not go to the eye doctor and get their eyes checked b/c they don't like the sensations. I hate the dentist and have lots of trauma behind it but I do it anyway because I would rather have my teeth than dentures. DS won't wear contacts. DD took three trips before managing. They still get annual eye exams because it's part of ensuring their health. These things have to be talked about, managed, and on you go. I, too, have many friends and acquaintances who were never allowed to use tampons and never had a sexual health exam but ended up teen parents behind actual sexual activity. That's cray. If you're grown enough to need an exam to see properly, keep your teeth, or engage in sex, it's my job to prepare you for it.

I don’t disagree with any of this post. I was just saying NOT liking going to the dentist shouldn’t affect someone’s “approval” for kissing lol 

I don’t wear contacts. I go to the eye dr, avoid the office that uses the measurement tool that touches my eyeball, and wear glasses. 

[ktgrok]

One can be utterly mature and responsible about their sexual and reproductive health and yet not be okay getting an IUD. It's not a necessary component of sexual health and care. It's but one option out of many. 

[Sneezyone]

1 minute ago, heartlikealion said:

I don’t disagree with any of this post. I was just saying NOT liking going to the dentist shouldn’t affect someone’s “approval” for kissing lol 

I don’t wear contacts. I go to the eye dr, avoid the office that uses the measurement tool that touches my eyeball, and wear glasses. 

Totally fine! Unlike eyes tho, if you're engaging in sex with even the remotest possibility of actually giving birth, there's gonna be cervical involvement(!) and no one knows how that's gonna go pain-wise, going in or coming out. My approach is just to OPENLY and HONESTLY acknowledge all the possibilities (including pain-free) up front and let the kid decide. 

[Terabith]

I would hesitate to do something like a hormonal IUD or implant before doing birth control pills because you don't know how the hormones will affect the person.  

My teens have both been on birth control pills.  Neither were having sex.  We tried them with my oldest because we thought it might help their depression/ anxiety.  It didn't really, but they did like how regular it made their cycle, so they stayed on it for awhile.  My youngest has incredibly irregular periods, and they've been very helpful for her.  But the first brand my youngest tried gave her her first ever migraine.  The other one caused no side effects, but the idea that something permanent with hormonal components would be put in and not be able to be easily removed would really give me pause in case there are bad side effects.  The pill seems like a much easier thing to tweak.  

[heartlikealion]

17 minutes ago, Sneezyone said:

Totally fine! Unlike eyes tho, if you're engaging in sex with even the remotest possibility of actually giving birth, there's gonna be cervical involvement(!) and no one knows how that's gonna go pain-wise, going in or coming out. My approach is just to OPENLY and HONESTLY acknowledge all the possibilities (including pain-free) up front and let the kid decide. 

Ok 

[Renai]

23 hours ago, LucyStoner said:

I had side effects from the pill and Mirena.  The side effects of the pill weren’t insubstantial for me- mood changes, loss of libido and weight gain.  Her mileage almost certainly will vary (I don’t think most women experience the degree of side effects I did with birth control but it’s far from unheard of either) but I frankly found that the side effects of birth control were very much minimized by my doctors when I asked about them.  After my first son was born, we used fertility awareness and barrier methods because I wasn’t willing to tolerate the side effects anymore.  

Some of the young women I know have had good experiences with the implant.  I would probably look at that over an IUD if it’s important to her to be on something before she’s sexually active.  

I also had side effects with Mirena. I had never experienced PMS symptoms prior (or they were so mild, I never noticed). I got the Mirena (after my first childbirth, csection), a little uncomfy going in but nothing major. My periods stopped after the first cycle. I started noticing that every month or so, I was an emotional maniac. I finally tracked it back to non-bleeding menstrual cycles. Like clockwork, every 24 days (how long my natural cycles were), I was a changed woman. I didn't last a year with it before I had my doctor take it back out.  Also during that time, dh said he could feel the string sometimes (not uncomfortable, just strange), and other times I could feel it (uncomfortable).

[ktgrok]

1 hour ago, Terabith said:

I would hesitate to do something like a hormonal IUD or implant before doing birth control pills because you don't know how the hormones will affect the person.  

My teens have both been on birth control pills.  Neither were having sex.  We tried them with my oldest because we thought it might help their depression/ anxiety.  It didn't really, but they did like how regular it made their cycle, so they stayed on it for awhile.  My youngest has incredibly irregular periods, and they've been very helpful for her.  But the first brand my youngest tried gave her her first ever migraine.  The other one caused no side effects, but the idea that something permanent with hormonal components would be put in and not be able to be easily removed would really give me pause in case there are bad side effects.  The pill seems like a much easier thing to tweak.  

Yup, and there are so many different options for birth control pills that they can usually find something that works. They vary both in what kinds of synthetic hormones they use and in dosage, etc. The ring is another easy to remove if it is an issue thing. My least favorite birth control was the Depo injection - made me nearly suicidal and there was nothing I could do but wait it out for the 3 months it stays in your system. UGH. 

[rebcoola]

I don't think the pain is supposed to be worse of you haven't had sex.  Just that the pain isn't worth it of you aren't active. I could be wrong it just comes up on teen girl group I am in that a lot of Docs won't even offer it.

[Sneezyone]

11 hours ago, rebcoola said:

I don't think the pain is supposed to be worse of you haven't had sex.  Just that the pain isn't worth it of you aren't active. I could be wrong it just comes up on teen girl group I am in that a lot of Docs won't even offer it.

I agree. A lot of docs won't offer it on the mistaken assumption that a) insertion is always painful and b) childbirth has ought to do with whether your cervix can tolerate an IUD. I was told my insertion would be easy because I had just given birth. No. My cervix opened swiftly and urgently upon demand with very little notice and closed right on up like a vise grip with the same speed. If your cervix operates this way it just does. I also was stupid enough not to see an expert who'd done insertions a million times. The base doc I saw was a freaking butcher who never even mentioned any kind of numbing agent. Never again. I loved having an IUD. I hated the experience. DD's experience was NOTHING like mine. Knowledgeable and compassionate providers made all the difference.

Edited February 19, 2023 by Sneezyone

[ktgrok]

3 minutes ago, Sneezyone said:

I agree. A lot of docs won't offer it on the mistaken assumption that a) insertion is always painful and b) childbirth has ought to do with whether your cervix can tolerate an IUD. I was told my insertion would be easy because I had just given birth. No. My cervix opened swiftly and urgently upon demand with very little notice and closed right on up like a vise grip with the same speed. If your cervix operates this way it just does.

The thing is, you don't know if your cervix is one that will be accomodating or one that will spasm the heck out and cause untold pain until after it is over. For me, the insertion pain was on par or worse than most of my labors. It was THAT severe of cramping, even with topical numbing stuff. The time with the numbing injection was much better, but cervix still wasn't happy, spit it back out, had to go back in and I was in pain for days with uterine cramps. And of course, most providers won't/don't use any anesthetic. Add in the trauma of taking it back out, with a chunk of my uterus, which again can't be predicted, and that's not something a lot of doctors are comfortable putting a teen through without compelling reasons when there are less invasive and painful options to try first. 

[Sneezyone]

1 hour ago, ktgrok said:

The thing is, you don't know if your cervix is one that will be accomodating or one that will spasm the heck out and cause untold pain until after it is over. For me, the insertion pain was on par or worse than most of my labors. It was THAT severe of cramping, even with topical numbing stuff. The time with the numbing injection was much better, but cervix still wasn't happy, spit it back out, had to go back in and I was in pain for days with uterine cramps. And of course, most providers won't/don't use any anesthetic. Add in the trauma of taking it back out, with a chunk of my uterus, which again can't be predicted, and that's not something a lot of doctors are comfortable putting a teen through without compelling reasons when there are less invasive and painful options to try first. 

Which is why I said, OFTEN, that is why I chose PP as DDs care provider because they offer numbing as a standard practice. It's why I think being open and honest about cervical issues isn't a BC thing, it's a potential gestating woman/girl thing and whether you discover this issue on the way in or the way out (prevention or birth) it needs to be discussed and acknowledged and prepared for. I don't give a flying flip about doctors who don't think touching the cervix can potentially cause pain except to avoid them like the plague. They're uninformed jerks. I wanted my kid to see an expert. I want to make sure the girls and young women in my orbit understand this is all within the range of NORMAL and that their experience can go in a variety of directions. They need people to tell them everything so they can make informed choices. Not offering options, all of them, is wrong and a red flag to me.

Edited February 19, 2023 by Sneezyone

[ktgrok]

48 minutes ago, Sneezyone said:

Which is why I said, OFTEN, that is why I chose PP as DDs care provider because they offer numbing as a standard practice. It's why I think being open and honest about cervical issues isn't a BC thing, it's a potential gestating woman/girl thing and whether you discover this issue on the way in or the way out (prevention or birth) it needs to be discussed and acknowledged and prepared for. I don't give a flying flip about doctors who don't think touching the cervix can potentially cause pain except to avoid them like the plague. They're uninformed jerks. I wanted my kid to see an expert. I want to make sure the girls and young women in my orbit understand this is all within the range of NORMAL and that their experience can go in a variety of directions. They need people to tell them everything so they can make informed choices. Not offering options, all of them, is wrong and a red flag to me.

Well, I mean, I'm not sure that how your cervix reacts to an IUD had anything to do with how it reacts to childbirth? 

And yes, all options should be offered, I'll agree with that, but the pain that is often associated with an IUD, and the risk of implantation/uterine damage/difficulty removing needs to be included in the discussion. Not dismissed. 

[kbutton]

23 hours ago, wathe said:

However, the absolute risk of stroke in women with MA on combined hormonal contraceptives (CHC) is small, and good quality studies specific to low-dose estrogen products are lacking [20]. Therefore, the use of CHCs in women with MA should be individualized. For those with a clear indication for CHCs, such as endometriosis or those who desire this method after a clear discussion of the risks, their use is reasonable.

Thanks for chiming in with up-to-date information!

IME, most women, even ones who have migraine with aura, do not know about the issue at all; hence, there is no discussion of risk happening. I asked two different OB/GYNs about what I read about clotting/stroke risks way back when I was first needing some kind of birth control, and they both told me it was no problem. The only nuance was about whether or not I might have worsened migraines vs. any discussion of stroke or blood clots. The stroke/blood clot thing was "fine." Not a risk. A few years later, after I was off the pill, a renewed set of warnings and awareness made the rounds, after a handful of women here and there died and someone noticed they were in the potentially at risk pool. (Seems like those warnings came along with warnings about smoking and BCPs.)

I highly suspect that it's not common to discuss the risks at all in a nuanced way given how often people are surprised to find out there is anything to be discussed. It's discussed on here from time to time, and there are always multiple people here who have never heard of this at all.

[Sneezyone]

20 minutes ago, ktgrok said:

Well, I mean, I'm not sure that how your cervix reacts to an IUD had anything to do with how it reacts to childbirth? 

And yes, all options should be offered, I'll agree with that, but the pain that is often associated with an IUD, and the risk of implantation/uterine damage/difficulty removing needs to be included in the discussion. Not dismissed. 

Is insertion pain related to the IUD or the competence of the providers, Katie? IUDs are used by millions of women without uterine implantation or complication. Every BC method has potential complications, including hormonal ones. We have millions of providers who don't know bupkis about women's health and still think melanin is a pain-blocker. We are our own best advocates and that requires full information and open dialogue. No one is dismissing the potential risks, just not elevating them among the risks of other methods.

Edited February 19, 2023 by Sneezyone

[ktgrok]

19 minutes ago, Sneezyone said:

Is insertion pain related to the IUD or the competence of the providers, Katie? IUDs are used by millions of women without uterine implantation or complication. Every BC method has potential complications, including hormonal ones. We have millions of providers who don't know bupkis about women's health and still think melanin is a pain-blocker. We are our own best advocates and that requires full information and open dialogue. No one is dismissing the potential risks, just not elevating them among the risks of other methods.

I had two different providers. One only used topical numbing on cervix, couldn't even get it in. (which is to my understanding more numbing than the vast majority of women get). I then called around and found ONE person who would do it with a cervical block injection.He also does ultrasound before placement,to assess the uterus and its shape, and again after to be sure it is located in the proper place. He certainly was the most qualified and competent I could locate in my major metropolitan area. The injection itself was still painful, and even though it was placed correctly (verified by ultrasound) it ended up migrating and being partially embedded in my uterus, so it took me coming back when they could do a cystoscopy to locate and remove it. 

Other women on this forum have had similar issues. Now, it wasn't life threatening, but it wasn't a non issue or a matter of me choosing a bad doctor. 

I'm not saying no one should get one. heck, I'm not saying I shouldn't have gotten one. I'm saying that 1. if done a provider who does pain meds is important, and ideally ultrasound first to be sure uterus has no abnormalities making it a bad idea, 2. there is significant pain associated for many women, and removing it is not always as easy as people try to make it out to be. 3. there are options with less pain and easier to stop if there are problems, that many would say are wise to try first. 

[SKL]

I do appreciate that recommendation to make sure the doc will take measures to reduce potential pain.

I talked to my kid and, for now, we agree to do the Pill temporarily to see if she has any concerning reactions to the hormones.  (Though, if she does, how would we know whether it was the Estrogen or the Progesterone?)

If the hormones don't pose a problem, we're looking at the Mirena, mainly because it lasts longer than the arm implant and various other methods.

If the hormones do pose a problem, I guess we have a difficult discussion regarding the copper IUD, kuz what else is there that doesn't involve hormones?

[ktgrok]

2 minutes ago, SKL said:

I do appreciate that recommendation to make sure the doc will take measures to reduce potential pain.

I talked to my kid and, for now, we agree to do the Pill temporarily to see if she has any concerning reactions to the hormones.  (Though, if she does, how would we know whether it was the Estrogen or the Progesterone?)

If the hormones don't pose a problem, we're looking at the Mirena, mainly because it lasts longer than the arm implant and various other methods.

If the hormones do pose a problem, I guess we have a difficult discussion regarding the copper IUD, kuz what else is there that doesn't involve hormones?

Nothing that is very effective, other than condoms, which really rely too much on the man. It really is sad this is where we are with contraception, STILL!! 

As for how you would know if it was estrogen vs progesterone, if one pill doens't work for her they will try another, and some have different levels of the various hormones, some are just progesterone (mini pill), etc. So if she does badly on a combo pill, but does well on a progesterone only pill, that would tell you. 

[Sneezyone]

1 hour ago, ktgrok said:

I had two different providers. One only used topical numbing on cervix, couldn't even get it in. (which is to my understanding more numbing than the vast majority of women get). I then called around and found ONE person who would do it with a cervical block injection.He also does ultrasound before placement,to assess the uterus and its shape, and again after to be sure it is located in the proper place. He certainly was the most qualified and competent I could locate in my major metropolitan area. The injection itself was still painful, and even though it was placed correctly (verified by ultrasound) it ended up migrating and being partially embedded in my uterus, so it took me coming back when they could do a cystoscopy to locate and remove it. 

Other women on this forum have had similar issues. Now, it wasn't life threatening, but it wasn't a non issue or a matter of me choosing a bad doctor. 

I'm not saying no one should get one. heck, I'm not saying I shouldn't have gotten one. I'm saying that 1. if done a provider who does pain meds is important, and ideally ultrasound first to be sure uterus has no abnormalities making it a bad idea, 2. there is significant pain associated for many women, and removing it is not always as easy as people try to make it out to be. 3. there are options with less pain and easier to stop if there are problems, that many would say are wise to try first. 

I didn't say it was a *NON ISSUE*, I'm saying it's no different from women who experience potential psychosis with hormonal methods. There are risks with everything. You simply cannot say that there is significant pain for many women because the default for providers is that it *shouldn't* cause pain and thus no pain meds/precaution are used. You are one person. As am I. I am glad I didn't extrapolate from my own experience to DD. She is thrilled with her choice and experienced minimal discomfort.

Edited February 19, 2023 by Sneezyone

[ktgrok]

I mean the default IS that it causes pain. 

That said, I'm sick, and exhausted, and probably being grumpier than I should be. I got offended by the idea that not wanting an IUD makes you squeamish, and you should suck it up since childbirth is worse. But probably you didn't mean it quite that way, and my cold medicated head is being obtuse. 

I'll go back to what we agree on - which is that anesthetic of some kind should be the norm, and it is misogynistic that most providers do not use it when inserting an IUD.