Mirena, the Intrauterine Contraceptive: A Testimonial

There was a time when I had a pregnancy scare. In fact, there were many times that I’ve had pregnancy scares though, in reality, they were all made up in my head.  Though I took my oral contraceptive pill every single day for seven years straight (perhaps missing only two tablets in all of those years), the thought of pregnancy absolutely terrified me. I was so uptight about preventing an unplanned pregnancy that, at random, I’d decide to be momentarily abstinent or use condoms with my long-term partner “just to be safe.” These episodes of unwarranted paranoia usually stemmed from learning that someone had “become pregnant on the pill,” and it would send me pacing into the pregnancy test aisle at my local pharmacy, sweaty-palmed and heart throbbing.

One thing was for sure: I did not want to become pregnant. Another thing that was for sure was that I wanted to continue having sex with my committed long-term male partner, as it was an important part of our relationship – and frankly, I enjoyed it. It would, however, create an unsettling environment for my partner and me, as he tried to understand – logically – my illogical fear (I was taking the pill as directed, I was protected), while still supporting my superstitious demands (no sex this week, I don’t know why, it’s just a “feeling”). Yes, I will admit it, I was neurotically afraid of an unplanned pregnancy.

So when I began working for Planned Parenthood, I learned the ins and outs of birth control: what was most effective, what most people use, and what the failure rates actually look like. I realized that the majority of pill-pregnancies are due to user error (not taking the pills), not failure of the method itself. Though facts subdued my irrational fears, I realized that there was another method available that could replace my daily pill-taking and better cure my unplanned pregnancy fears!

Folks, I present to you: the Mirena IUD/IUC (Intrauterine device or intrauterine contraceptive). Mirena is a small “T” shaped contraceptive device that is inserted by a clinician into the uterus, where it remains for up to five years (it can be removed at any time before). It is made of plastic and includes the hormone progestin, which works to cut down on menstrual bleeding. What’s the best part? It’s 99.3% effective in preventing pregnancy for FIVE WHOLE YEARS! No more daily pill routine! No more paranoid trips to pregnancy test aisle! For me: no more pregnancy scares!   

 I am a Planned Parenthood employee, supporter, advocate, donor and yes: patient. I have first-hand knowledge of the cutting-edge quality care that our organization provides, so I asked a Nurse Practitioner that I work with if she would insert my Mirena. Excitedly she agreed, and I booked an appointment for a couple of weeks ahead, when I would be menstruating (FYI: we recommend inserting IUD/IUCs while on one’s menstrual flow).

The morning of, I was consumed with adrenaline-shaped butterflies, nervous that the procedure would hurt or that the dreaded “XYZ” of my imagination would go wrong.  Luckily, my dear friend and colleague E.G.Hannah was there to assist the clinician and calm my nerves. I took 800mg of ibuprofen before I arrived. I put a maxi pad in my underwear in case of any post-insertion bleeding. I also took a medication to prepare my cervix beforehand since it had never been dilated before.  Heart pumping, hands sweaty, I undressed from the waist down, dragged the crumply paper drape over my quivering thighs, and prepared for five years of security.

The insertion process itself was uncomfortable, but to be truthful, the worst part was my anxiety. I was intimidated by having anything inserted into my uterus, as I’d never encountered that sensation before, and I was pretty sure it wouldn’t be a cakewalk. However, I’d seen them inserted many times prior and the vast majority of women did totally fine, with minimal complaints. I remember looking down and seeing my legs wobbling, shaking so hard with anxiety, I felt really ridiculous. Lucky for me I was surrounded by supportive and understanding people who talked me through it and I was done within five minutes. Yes, it was uncomfortable. It felt like pressure and menstrual cramping for about three minutes. I’m pretty sure I uttered some profanity and then, within a matter of minutes, it was over. I had five minutes of discomfort for five years of freedom. In my book, it was a remarkable trade-off.

I went home and took some more ibuprofen throughout the day, as I had menstrual type cramping that lasted through the afternoon and into the night. The next morning I woke up feeling completely fine and no – I didn’t have any bleeding.

I waited about a week before I had sex. My partner was able to feel my strings a couple of times but I had them trimmed a month later and he hasn’t complained since. I haven’t had any menstrual bleeding since the day it was inserted three years ago. Better yet, I haven’t had any pregnancy scares!

This method, for me, has absolutely changed my life. Mirena has given me freedom and confidence. I now have the luxury of separating intercourse from pregnancy in my mind because I know I’m covered. Once a month I feel inside myself to confirm the soft tiny strings are still accessible (they curl up around the cervix and are needed for eventual removal by a clinician). Three years ago I “set it” and now I can “forget it.”

In two years my Mirena will need to be removed, and at that time I plan to have another one put in its place. For me, Mirena was an absolute dream come true: no periods, no pills and no unplanned pregnancies!

As a reminder, the Mirena is not for everyone and there are certain health conditions that are contraindicated for its use. Speak with your trusted health care professional to see if you’re a candidate for this method. Also, you can check out more information about this long-acting reversible contraceptive method below:

● IUD info you can trust from Planned Parenthood’s website

● Mirena’s official website

● Mirena info on Bedsider (includes user testimonials)

Readers, have you ever used an IUD/IUC? What’s your favorite birth control method?

 

Pregnancy Prevention: What to Do If You Miss One, Two, or Three Pills

Birth Control PillsBirth control pills are more than 99% effective in preventing pregnancy as long as they are taken as directed. Having said that, birth control pills are a hormonal contraceptive method that must be taken orally every day at roughly the same time. (Progestin-only pills that do not include estrogen must be taken at exactly the same time every day in order to be effective and missing even one can lead to pregnancy; therefore the rules below do not apply to them.)

For many pill users, there will be at least once in your life when you miss taking your pill at the correct time. Don’t beat yourself up about it, but be prepared in advance for what to do in that scenario to continue keeping yourself protected from an unintended pregnancy.

The following are some general rules to follow in regard to combined hormonal contraceptive pills (estrogen and progestin, which are the vast majority of pills prescribed). As a reminder, in these pills the first three weeks are considered “active pills,” meaning that they include the active hormones needed to prevent pregnancy; the fourth week in a pack are considered “placebo pills” which do not include active hormones, and are taken during the menstrual flow portion of your cycle. If you are taking progestin-only pills, every pill in the back is considered active, and you must take them all!

If you miss one of the active pills: take it as soon as you remember and continue as normal with your pack.

If you miss two active pills: take them as soon as you remember but also use a back-up method like a condom (or abstinence) for one week.

If you miss three active pills: abandon the pack and use a different method for protection from pregnancy (like condoms or abstinence) until you have your next period. Begin a new pack the Sunday after your period starts, but continue your back-up method for one week, as you’re not yet protected from pregnancy.

If you mess up on your pills and had intercourse you believe wasn’t protected, you can take emergency contraception up to 72 hours afterward, most effective as soon as possible after the unprotected sex act. Again, if you’re 17 or older you do not need a prescription, but the medication is typically held behind pharmacy counters or at Planned Parenthood. If you’re under 17, you will need a prescription. (By the way, teens get discounted pricing at our affiliate.)

Also, if you find yourself forgetting two or more pills regularly, you might want to consider changing to a contraceptive method that does not require daily use, like the patch (weekly), the ring (monthly), the shot (every 3-4 months), the arm implant (three years), or an IUD (up to 5 years or up to 12 years).

As always, we recommend you use condoms in addition to your birth control method as a way of protecting against sexually transmitted infections, including H.I.V.

Need a text reminder to remember your pills/patch/ring or shot? Check out the free text-reminder service offered through Bedsider!

2012 Florida Legislative Session: A Victory!

It’s hard to believe, but it’s true: the 2012 Florida Legislative session officially ended Friday night and not one anti-choice bill was passed this year!

Despite persistent threats to reduce women’s access to reproductive health care – 10 anti-choice bills were introduced during this session, while a whopping 18 were introduced during 2011 – the Florida Legislature did not send the Governor any legislation for his signature that would reduce women’s access to essential health care services.

This is a great victory for women!

For those energetic souls who called, wrote or visited state legislators on behalf of women – thank you so much for your efforts and dedication! Without supporters like you, we would not have been able to stop the dangerous, invasive and restrictive bills that had been proposed. We are particularly encouraged that many legislators said “no” to efforts targeting health centers that provide the reproductive health care and family planning services that women need.

The “Women’s Health at Risk” report, released by the Florida Association of Planned Parenthood Affiliates, reveals that women’s health is in crisis in Florida, as women struggle to access affordable, quality health care. Nearly two million Florida women do not have health insurance – and nearly as many are in need of contraceptive services.

Would we be out of minds to hope that, now, legislators will work with Planned Parenthood to help women access quality reproductive health care services?

Well, we’ll just keep showing up in Tallahassee, and asking, and testifying – and we’ll continue growing our army of women and men who will not stop until women in Florida have full rights to health care!

Happy Roe v. Wade Day!

As you may know, January 22nd was the anniversary of Roe v. Wade, the landmark Supreme Court case that upheld women’s right to have an abortion based on her right to privacy in her medical decisions.  This decision legalized abortion in the United States, saving many women’s lives and granting them freedom over their reproductive choices.

An unmarried pregnant woman who sought abortion, a doctor who was at the time being prosecuted for performing abortions, and a married couple concerned about their future of pregnancy and contraception brought forth the class action suit in 1973.  Though it was determined that only the woman (Roe) and the doctor (Hallford) had standing to sue, after a month of debate it was decided that women could not be prohibited from having an abortion in her first trimester based on the right to privacy given by the Due Process clause of the 14th Amendment to the Constitution.

Thanks to this decision, most of us have grown up living in a country where abortion is legal. Most of us have never had to consider having an illegal abortion, or worry about a loved one getting sick or dying from an unsafe procedure.

It may seem, especially to younger people who have grown up with the right to have an abortion if they choose, that Roe v. Wade is a solid institution, safe and here to stay. But please, don’t take your medical privacy for granted.  Enemies of reproductive rights are working hard to chip away at them, proposing laws that allow the government to intervene between you and your doctors medical decisions.

Already in Florida we have a law mandating that women view and hear a description of their ultrasound before a pregnancy, a move meant to shame and intimidate a woman seeking a termination. Personhood laws, which would outright ban abortion in the state in which they pass, are being proposed nationwide. Again in Florida, Representative Charles Van Zant is introducing for the 3rd time his Florida for Life Act that would ban abortion except if the mother’s life is at risk, a devastating move for women and an outright challenge to Roe v Wade.

Get involved in the fight, stay aware of what your politicians are working on, and don’t assume that your ability to obtain an abortion (or even birth control!) will be around forever without help. For up to date information about what’s going on in your state and how to take action, please consider signing up at the Planned Parenthood Action Center, or look at other ways to get involved at Planned Parenthood.

Pregnancy: Factoring in the Rh Factor

Need a reason why science is amazing? I’ve got one for you. In 1940, the blood from Rhesus monkeys helped find a factor in the blood that plays a critical role in maternal and fetal health, greatly increasing the chances of a healthy pregnancy.

It’s called the Rh factor (Rh after rhesus, get it?).

What Is It?
The Rh factor is one of many antigens that protect your blood cells from foreign or internal substances. However, the Rh factor can be a complication in pregnancy.

How Does It Work?
You can either be Rh negative or Rh positive (antigen is not present in your blood vs. antigen present in your blood). You’re tested for this blood factor between 24-28 weeks or if you decide to have an abortion. If you’re Rh positive? You don’t have to worry about it. However, if you’re Rh negative, it’s a problem.

Your Rh negative factor is usually not a problem in your first pregnancy as very little blood between the mother and the fetus is exchanged during the pregnancy. But maternal and fetal blood can be exchanged during the delivery or during an abortion procedure – and that’s where the Rh problems come in.

If you’re Rh negative and your partner is Rh positive, there’s a 50% chance that your fetus is Rh positive. (Scroll down on this link from the Mayo Clinic to see a helpful chart for how this all works.) So, when your Rh negative blood mingles with the fetus’ Rh positive blood, your own blood can produce antibodies that will attempt to repel your next Rh positive pregnancy by treating it as something that will harm you, sometimes resulting in miscarriage or by giving the baby a life-threatening illness, HDN (hemolytic disease of the newborn).

Luckily, we’ve got great medical remedies to solve the Rh problem.

What Can Be Done?
If you’re Rh negative, an injection called RhoGAM is given to you so that your Rh negative blood does not produce antibodies against your potentially Rh positive fetus. You’ll also receive another shot of RhoGAM within 72 hours of delivery if the baby is found to be Rh positive. You will also receive shots of RhoGAM in all of your subsequent pregnancies to make sure the problem is solved.

The Rh factor was once a leading cause of infant mortality, and today the problem’s virtually been eliminated from the developed world.

Isn’t science great?

Birth Control, Blood Clots, and Headlines – Oh My! Looking at Pills in the News

There have been a lot of headlines in the news recently about the risks of birth control pills, and increased dangers of blood clots. It’s not always made clear right away in these articles that these concerns are limited to a particular kind of hormone, not all birth control pills.

Here’s the deal: most birth control pills on the market contain both estrogen and progesterone. There are several different kinds of synthetic progesterone on the market, and the kind used in the pill varies between brands.  Yasmin, Yaz, and their generics use drospirenone. It is this hormone that the FDA is currently concerned about, as there is recent evidence that the risk of forming blood clots, a potentially fatal side effect, is slightly higher on this medication than others. Just a week ago the FDA voted 21-5 that the labels for these medications should be updated to include more information about the risks; however, the pills will be kept on the market. Other, older birth control pills are not under investigation by the FDA as neither their effectiveness nor their safety has been called into question. Bloomberg at Businessweek did a small survey and found that many doctors are still choosing to prescribe Yasmin and Yaz, as the risk of blood clots is still very small and they have patients who are happy on the medication. It is important to note that on any birth control pill the risk of forming a blood clot is minuscule, especially for non-smokers under 35; in fact “the most recent study by the FDA found women taking Yasmin had a 75 percent higher chance of suffering a blood clot than patients taking a combination of older drugs. The absolute risk of a blood clot is still far less than a fraction of a percent”…It’s also been noted that some “studies suggest that 10 in 10,000 women taking the newer birth control pills will experience a blood clot, compared with 20 in 10,000 women who are pregnant or have just given birth.”

Overall, the birth control pill is still a safe and effective option for most women. If you are on a birth control method or need one and are concerned about your health risks, please talk to your health care provider.  You can also find good information about your birth control choices, their effectiveness and their risks at Planned Parenthood or Bedsider.

Your Guide to Alternative Menstrual Products (Because Tampons and Pads Can Be a Total Bummer)

Walk down a “feminine products” aisle in any drug store and you will almost always see shelf after shelf of the same two things: tampons and pads. Tampons with applicators, without applicators, with perfume; pads, with or without wings, plastic sticky mini-diapers that smell like chemicals, or worse, perfume. These two products have probably been a staple of your life at least once a month for a while now, and if you’re like most of the women I know, you don’t like them very much.

Tampons can be uncomfortable and can leak, and if you try to avoid leaks by using a more absorbent one then you risk having to pull an abrasive tampon out of a dry vagina – it’s not only terribly uncomfortable but can put you at increased risk of infection and disease.  Tampons, especially super-absorbent tampons, can absorb too much fluid, drying out the vagina and increasing the possibility of micro-tears upon removal or insertion of the next tampon.  These tears can provide a window for the bacteria Staphylococcus Aureus, which is commonly present on our skin and can get pushed into the vagina during tampon insertion, to get into our system causing Toxic Shock Syndrome.  TSS is “a severe disease that involves fever, shock, and problems with the function of several body organs…[it] may be deadly in up to 50% of cases.

Pads are not any fun either; they feel diaper-like and crinkle and irritate delicate skin that was not meant to have wet plastic rubbing against it.  Not to mention that environmentally, disposable tampons and pads are a disaster waiting to happen.  So much extra waste for landfills! So what’s a girl to do? The good news is there are a lot of other options about there that are easier to use, more comfortable, environmentally friendly, and cheaper.

Read more…

Houston, We Have a Vulva Problem

I recently received a phone call from one of my friends who told me that our mutual friend, who is pregnant, asked if the baby was going to come out of her pee hole.  I was flabbergasted because this woman is college-educated and 30!  I would have assumed that somewhere along the way she would have stumbled upon some information about her Vulva.  This incident reminds me of the episode on The Office where Dwight asks Toby where the clitoris was located.  I agree with Toby, our public school system and parents have obviously failed many of our youth when it comes to basic sexual and reproductive health information.  If you or a loved one has never been introduced to the glorious vulva, then today is your lucky day!  If you would like additional information on how to feel more comfortable and accepting of the area “down there” or watch this clip from Oprah.