The case of the tiny little IUD vs The Stay at Home Feminist.

I have had more than a few 'foreign' materials in my body over the years. I have titanium hip joints and polyethylene and ceramic hip sockets.

I have had surgical steel rings pierced in my belly button and various parts of my ears.

And up until 6 weeks ago I had a tiny little T-shaped polyethylene and hormone-filled device in my uterus.

Yes, I am talking about the ever popular intrauterine device known as Mirena.

Three and a half years ago, after Princess L was born and we were pretty darn sure that we did not want anymore babies, this seemed like a really great birth control option. Easy office appointment to have it put in place, minimal side effects (more on this in a bit), safe to use while breastfeeding and no need to even THINK about having an oops baby for at least 5 years. What was not to like about it?

Mirena.jpg

 

So in I went to get it inserted and off I went on my merry way, having glorious birth-controlled sex with my husband for the next three years without a care in the world. (Uhm, do not try to confirm this with him, his version MAY be a bit different than mine... 2 babies under 2 years old people!!)

I thought I had hit the jackpot of birth control. I really didn't feel like I had any major side effects from Mirena. And I stopped having a real menstrual cycle and period for the three years that I have had the Mirena in place.  I have not had to purchase more than a few boxes of panty liners to deal with dear old rarely visiting Aunt Flo and I told all my friends about Mirena and I have recommended it to lots of mamas.

I was the poster-mama for Mirena!

Or was I?

In the past three years, I have had two major bouts of depression. One I chalked up to postpartum depression (PPD) after Princess L  and one I felt was due to life just overwhelming me.

I have been so severely fatigued for the past two years that no amount of sleep could fix it and no reason identifiable on any blood work or medical test has been found that would explain it medically. This too I attributed primarily to having a newborn and a 22 month old, tandem nursing, and kids that needed a lot of night-time parenting. And later to me just doing too much and staying up way too late trying to get it all done.

I have had multiple episodes of such severe bloating and abdominal pain that I have had an ultrasound to rule out a ruptured ovarian cyst, a trip to the emergency department for a suspected appendicitis, and I have spent multiple nights doubled over and writhing in pain in bed with no relief from any and all forms of over-the-counter anti-gas medications.

I have lost whole handfuls of hair and have the perpetually clogged shower drain to prove it. I thought as first that this was the normal, post partum hair loss phenomenon, but it has continued for three years. I have to clean my hair brush at least twice a week and could have probably made a whole new head of hair with all that I have lost so far.

In the past 6 months I have had more migraines than I have had in my entire life. I never really understood when people would say, "I have a migraine, I have to go lay down" until now. I have had such bad headaches that I have had to turn off all the lights, close the blinds and just lay on the couch with my eyes closed while the kids watch a movie. The last few have been so bad that on those days, as soon as my husband would get home from work, I ended up crashing in my room for multiple hours, waking only to pee and drink water.

And while we are talking about my husband, remember a few lines ago when I said I was having wild birth-controlled sex? Well, we would have been had I had any kind of libido to speak of! I am serious, it slowly but surely disappeared on me completely this past year. Poor dude... and poor ME! Because I kind of like sex and all that goes with it!

And finally...

I have been working out with a personal trainer for the past year. I watch what I eat, I don't drink, I don't over-indulge in sweets or snacks, and I am relatively active given my limitations due to RA. And for the last year I have been trying to lose the same 15 pounds and the scale has not budged more than 3-5 pounds.

Why is all of this relevant you ask? And what does it have to do with Mirena?

Well, have a look at the list of COMMON side effects listed in the product prescribing information for Mirena.

*The HIGHLIGHTED ones are MY symptoms.*

What are the more common side effects of Mirena?

Possible common side effects of Mirena include:

Discomfort during placement. Pain, dizziness, bleeding or cramping may occur during placement. This is common. Let your healthcare provider know if the cramping is severe. If these symptoms do not stop 30 minutes after placement, Mirena may not have been placed correctly. Your healthcare provider will examine you to see if Mirena needs to be replaced or removed.

Expulsion. Mirena may come out by itself and no longer prevent pregnancy. Symptoms of partial or complete expulsion may include bleeding, pain and an increase in menstrual flow. If this occurs, Mirena may be replaced within 7 days of a menstrual period after pregnancy has been ruled out. If you notice Mirena has come out, use a back-up form of birth control like condoms and call your healthcare provider.

More than 10% of Mirena users may experience:

  • Missed menstrual periods. About 2 out of 10 women stop having periods after 1 year of Mirena use. Your periods come back when Mirena is removed. If you do not have a period for 6 weeks during Mirena use, contact your healthcare provider to rule out pregnancy.
  • Changes in bleeding. Your period may become irregular and you may have bleeding and spotting between menstrual periods, especially during the first 3 to 6 months. A few women have heavy bleeding during this time. After your body adjusts, periods usually get lighter and the number of bleeding days is likely to decrease, but may remain irregular. Or you may even find that your periods stop altogether—in which case, you should contact your healthcare provider to rule out pregnancy.Call your healthcare provider if the bleeding remains heavier than usual or if the bleeding becomes heavy after it has been light for a while.
  • Pelvic and/or abdominal pain may occur. Talk to your healthcare provider if the pain is persistent.
  • Cyst on the ovary. About 12 out of 100 women using Mirena develop a cyst on the ovary. These cysts usually disappear on their own in a month or two. However, cysts can cause pain and may sometimes require surgery.

Between 5% and 10% of Mirena users may experience:

  • Headache/Migraine
  • Acne
  • Depressed mood
  • Heavy or prolonged menstrual bleeding

Less than 5% of Mirena users may experience:

  • Vaginal discharge
  • Breast pain or tenderness
  • Nausea
  • Nervousness
  • Inflammation of cervix, vulva or vagina
  • Pelvic pain during your period
  • Back pain
  • Weight increase
  • Decreased sex drive
  • High blood pressure
  • Pain during intercourse
  • Anemia
  • Unusual hair growth or loss
  • Skin irritations (such as hives, rash, eczema or itching)
  • Feeling bloated
  • Swelling of hands and/or feet
  • Expulsion

Every individual responds differently to medication, so talk to your healthcare provider about your individual risk factors and to see if Mirena is right for you.

And here is something else I did not know. The hormone used in Mirena is called Levonorgestrel and is often referred to as a 'progestin', which kind of sounds a lot like the naturally occurring  hormone progesterone right? WRONG. Levonorgestrel is a hormone disrupter and has the opposite effects as our own progesterone (which only makes sense really given that progesterone is often called the 'pregnancy hormone'). Levonorgestrel is also the active ingredient in the Norplant birth control implant (which is no longer available in North America) and also at higher doses is the drug that makes up the Plan B or 'morning-after' pill(s). Huh? The things they don't tell you at the doctor's office....

Here is how this all played out for me and how I figured out what {I believe} was going on in my own body.

About 4 months ago a friend of mine got her Mirena IUD inserted. And a couple of months after that she told me that she was not convinced about it and was having some issues. She was tired all the time, was bloated and had gained about 5 pounds on her VERY fit and tiny runner's body. It was around this time that I started to put two and two together and realized that all of the annoying and kind of non-specific symptoms I had been having for the past few years, might also be related to MY Mirena IUD. I started to do more research.

To be completely honest, I have wanted to have my IUD removed for about a year. I went to see my family doctor about it in 2011 and told her I just didn't want any more foreign substances in my body. At that time she convinced me to keep it in so that we did not have to worry about getting pregnant before SOMEONE had a chance to book his snippity-snip appointment (still not booked BTW)!

Six weeks ago I saw my doctor once again. We went over my list of concerns, what I had found out about the side effects of Mirena, and what I wanted to do about it. She insisted on ordering another laundry list of blood tests, which all came back completely and utterly normal, and a week later at another appointment I finally had the offending little piece of plastic removed from my body.

I have to say, I feel better without it. Whether this is a placebo effect or real relief from the side effects, I don't know for sure. I do know that there have been no more excruciating cramping and bloating, I haven't had a migraine in five weeks, and the 'I can't even keep my eyes open while driving' extreme fatigue is gone. Oh, and that little problem with my libido... that seems to be gone too, which is making someone else around here very happy!

This week for the first time in over four years, dear Aunt Flo came for a REAL visit. To honour this occasion, I took another step in the direction of living a more natural life and invested in my first ever Diva Cup.

So what is the moral of the story here?

Mirena may sound like the perfect birth control solution and for some women it may well be... BUT please be aware of ALL of the side effects, and what can happen to you while on this medication. Do some research, ask around, and make sure that this is the birth control method  that really is for you. There are whole blogs and websites dedicated to the stories and cases of women's lives with and then after Mirena and some of them are pretty scary. And while these may be some extreme cases, they made me pause and re-evaluate the role that Mirena has played in my life and convinced me to have it removed.

I really wish I had known more about this sooner and had stuck to my guns a year ago with my GP and had it taken out then.  But here I am now, I know better, and I now have one less foreign object and synthetic chemical substance in my body.

And that is a good thing.

Natasha~

Have you used Mirena? What has your experience been?

UPDATE: One year post Mirena. Here is my follow up post a year after I had the Mirena IUD removed.

A Mama's Story of loss. Guest Post.

Pregnancy is a lot of things. It can be a joyous and wonderful time in a woman's life. A time filled with hopes and dreams for your future child and your family.  And when a pregnancy is lost, all of those hopes and dreams are shattered. My blog is a place of sharing, of all of the experiences of motherhood and I am honoured to provide my friend Jacqueline Neher from Urban Chickadee a chance to share her story and to help her in her healing journey.

For those of you who do not know me, I am Jacqueline Neher. I am the co-founder of Urban Chickadee, Edmonton's premiere baby planning company and I deal with all things pregnancy and baby on a daily basis.  Ironically, here I am writing my story of a pregnancy loss.  I am doing this in an effort to heal, and to share.  My story reflects my shattered hope and the heart breaking loss that comes with a miscarriage.

Let me take this back to December 2011.  We had just found out we were pregnant after over nine months of trying.  A person can only take so much rejection, and I was scared to even do the pregnancy test. With all the hope and anticipation I could muster up, I took the test and sure enough there was a "+" sign on that little stick. We were pregnant!  My husband was at work until later that morning, and I decided to text him a picture of the stick - he was elated! The day was perfect!

We were going to wait to share the news with everyone until Christmas. We had our daughter’s 2nd birthday coming up, and wanted to embrace her time for what it was.  My excitement got the better of me though, and I told my sister.  I then I told my mom, and from there it slowly escalated to our entire immediate family and some close friends.

The timing of this pregnancy was absolutely perfect.  My first trimester would be over on my birthday and we were due in the summer.  I was not particularly looking forward to being pregnant in the heat, but I was excited because my mom would be off work and she would be able to provide the extra help we needed.  It seemed like everything was working out in our favour! The nine months of trying would finally be paying off.

It wasn’t long before I found myself into the 9th week of pregnancy.  I started to spot and my heart began to shatter. My gut wrenched at the sight of the little bit of blood.  For those of you familiar with pregnancy and miscarriage, you will know that this can often occur and mean nothing.  At the same time I was sick about the other possibility.   I tried to act like it was nothing, but all day I was out of sorts. Then it happened again the next day, and that horrid feeling in my stomach would not go away despite my efforts to brush it off. In an attempt to ward off any potential loss of this baby I even tried not to do anything too physical and eat healthier.  I told myself that maybe, just maybe, this could be the cause of the bleeding and I could stop it. This was all happening over the weekend it wasn’t until Monday that I could call my doctor. I held on to the hope that everything would be OK.

When Monday arrived I was able to get an appointment to see my doctor.  They sent me for blood tests that would check to see if the pregnancy hormones were still going up.  Thursday came, and my doctor called to tell me that the hormone levels were not rising, they but were still high.  She asked if I was still bleeding, and I told her it was down to very minor spotting.  To further assess the pregnancy I was booked for an ultrasound the next day – the morning of Friday the 13th. I’ve never liked that day.  Maybe because of all the superstitious and bad things thought to occur on it.  Turns out Friday the 13th can indeed bring bad luck, as we were about to discover.

During the ultrasound I knew something was wrong.  The technician kept asking me "Are you sure your dates are correct?”.  Of course I was!  Throughout our attempt to conceive I had been charting and watching my cycles closely.  The technician left to go get my husband, telling me "this is the hard part of my job".

There I was, left on the table with an ultrasound scope in-between my legs (oh yes - always fun).  I waited to be told the news and tried to hold back tears (and of course the scope in-between my legs). The technician came back into the room with a parade - my husband, my daughter, and the radiologist. The radiologist and technician stood there, gazing at the screen and tilting their heads.  They told us that even though they couldn’t get a good look at the "baby" it was only measuring at about 5-6 weeks. Apparently this is neither “good news nor bad news”, and they could not confirm anything. Either our dates were just wrong, or the "baby" wasn’t growing.

So we left... my husband remained the optimistic one, but I was not. I assumed the worst. We got home and talked things out. I Googled for hours and came to the conclusion that everything was still going to be OK.  My hope returned.

We waited for my doctor to call on Monday. She was not feeling good about the ultrasound, and she wanted to do another blood test. At this point I was so MAD at her! I wanted her to at least be a little optimistic. Why was she being so negative?  Why can’t we just wait? Despite my anger I trudged off to the lab to be pricked again. When I got home all I did was pray and hope.

My doctor called at 8 AM the next morning. The hormones had decreased again…and with that news, all my hope was gone.

We lost our baby.

I felt my heart shatter and watched as my husbands did too.  We emotionally broke down and shared that pain with one another.  Our two-year old daughter stood there watching us sob into each other's arms, not knowing why.  Thoughts ran through my head: be strong, don’t be silly, this is no one’s fault, it’s only 9 weeks – get over it!  This is not something you can just get over and I cried for the baby we will never meet, for the milestones that won’t be reached and for having to start attempts for a pregnancy all over again.  I felt so cheated.

And as if that emotional turmoil wasn’t enough, my nightmare continued.  I was told I would have to decide how I would like to "take care of this" miscarriage.  They call my situation a missed abortion (what a horrific term) and refer to this unborn child as a fetus or embryo.  I cringed at the medical terms and tried to make sense of what was happening.  My mind fought to detach from the fact there is no "baby" and the fact that it has not left my body yet.  A decision has to be made on how that is going to happen, and the nurse from the Early Pregnancy Loss Clinic walked me through my options.   All  of the options are upsetting and the nurse tells me that they don't like to do surgery, so my best one is to insert some pills. The pills that will end it all. When I talked to the nurse I just wanted this whole thing to be over, I didn't even want to go another day.  I began to think of it as a fake pregnancy and I just wanted it to be done. I asked how soon I could get the pills and I planned for the weekend.

It's a surreal thing to plan your own miscarriage.  You go through so many emotions.  You wonder, is this really true?  Can we just get this over with?  You question if you can even get through it. You fear it is not really done.

The nurse described the horrific physical symptoms that may present during the process and we planned for my daughter to be with my mom.  I didn’t want her to see me in any more pain and my husband wanted to be there for me. The morning I inserted the pills my husband and I braced for the worst.  We waited... and waited... and waited... finally there is a bit of cramping and some blood, but nothing like they said it would be. My daughter came home from my mom’s place and we all sat in bed and watched TV together.  I thought that maybe it won’t be so bad and checked in with the clinic. The clinic staff did not think I had miscarried yet and apparently the first dose of pills only works for 60% of women. I have to do it again.

The second attempt worked and it was SO bad. I won't go into the gory details, but it was the worst day of my life! I believe my mind tried to protect me and I felt numb. It was as if I couldn't process what I was actually going through. Then it continued...

...for three more gut-wrenching days.

I am now an empty shell.

Looking back at the last few months I think the only way I could have gotten through all of it was because of the support of my husband, who grieved with me and cared for me. I am also so glad that I reached out on social media. I can not believe how many people shared my story and reached out to me. I did not feel so alone.

In an effort to move on, we’ve planned a special trip for our little family.  My focus will be on a healthier lifestyle for the future as I try to forget about the loss. Every once in a while it still hits me like a brick wall, but I try to refocus my thoughts and get through the moment.

My husband is such an optimist, and he tells me that this is one more experience I have to relate to with people in my life and in my business. My grandmother always tells me that "God only gives us what we can handle”. I guess God thinks I am one hell of a strong woman. If that’s the case, then that is what will be.  I will be strong for me, my daughter, my husband, and for the future children that will grace this family.

 

Jacqueline Neher became mama to Little Q in 2009 and is one half of the amazing baby planning and design company, Urban Chickadee.

You can follow her on Twitter and on her Facebook page for all the latest in design trends for babies and the mamas and daddies who love them!