My birth control saga is still an ongoing battle...
When Skyla expelled, I had the plan to get one again. After all, this one didn't expell because of my uterus, it expelled due to the menstrual cup (uncomfirmed, but that is my theory and it has been come what confirmed by one OBGYN). So, I made another appointment to get another IUD. However, I was dreading the pain. A lot.
As I was sitting in the waiting room, hoping that 4 Motrin would do the trick for the pain this time, I started to second guess another IUD. As I sat there, I debated my other alternative .... The arm implant! I tried really hard to remember all my issues with it and really tried to remember if it lowered my sex drive or was it my circumstances? Was I just not being diligent enough about losing weight when I had it? As I recall, I got it removed because I couldn't lose weight. But what if I tried harder this time around?
I told the nurse that I wanted to talk with the doctor before doing the IUD, because I couldn't really say for certain that this was what I wanted anymore. Since the office was a bit behind, I saw an attending doctor, who was really awesome.
Here is a fun list of things we discussed:
1. Another IUD probably wasn't the way to go
2. The menstrual cup probably didn't cause the expulsion
3. With careful monitoring, I could do a regular pill form of birth control
4. The arm implant is a good choice for me
5. They will do another IUD, but they don't recommend it because each insertion carries more and more risks
6. I should think about which option I wanted and come back in a month do discuss it again
7. For now, she recommended the mini pill
She was one of the nicest doctors I'd ever talked to who really listened what I had to say and how I felt emotionally about my experiences. I was about to commit to the implant, but she said I should wait before I make a decision.
She suggested I at least see the doctor I had an appointment with, if nothing else just to be introduced. So I waited a bit more and then heard some discussion about Lamictal just outside the door.
The doctor and the attending came in, fulling admitting they were arguing over my case.
Here is another fun list of what this doctor told me:
1. She HAS seen cases where menstrual cups pull out IUDs!!!!
2. She said that after 2 expulsions, normally they don't recommend IUDs anymore (and she was shocked i wanted another one)
3. The best options for me, in terms of effectivness are: IUD, Depo, Implant, Mini Pill. Obviously, the IUD was off the table, but she said the Depo shot was my next best option, however since I am sensitive about weight gain, then I probably wouldn't want to do that.
4. Progestrone only birth control lowers the brains threshold to tell when you are full, so many women over eat which causes weight gain. If you are aware of that, you can modify your diet to accommodate for the change.
5. My seizure meds causes any form of bc to be metabolized faster than normal, which is a problem for something like the mini pill because it has to be taken at the same time everyday even for normal people. Making the mini pill a bit of a risky form for me to take.
I can't really say they pushed one form over the other (unlike everyone pushing Mirena over Skyla to the point of worry), but they did emphasize that I think about all my options.
Later, I stewed over the info about Lamictal metabolizing BC faster than normal and I came to an interesting thought.
For those who have read through my posts, you know that my first time with Skyla was fine until about 10 months in, and then I started getting periods every 2 weeks. And when I got it checked out, they said my IUD was in place and that the strings were on the short side. Then, after another round of heavy bleeding, I got a second opinion and an ultra sound, only to find out the IUD had become slight dislodged. It was about 3 weeks between the two appointments, and I was bleeding both times. It's also known that explusion rates are higher when you are on your period, heavy bleeding can dislodge the IUD. When I got my ultra sound, it showed that just one edge was slightly out of place. Otherwise, it was normal. So that really wouldn't explain why I was bleeding so much and so often. But I do know that the heavy bleeding happens when the hormones leave your body and you get an imbalance. It happened to an extreme after I got Skyla removed and Mirena. Those hormones leaving my body causes crazy heavy bleeding. So, my thought was that Lamictal metabolized the Skyla hormones so fast that it lowered the hormones to the point to cause that kind of heavy bleeding. It would also explain why I still had periods on Mirena, when most women don't get periods after 6 months of having it in!
This is just a thought, of course. Can't really confirm that but maybe I will bring it up at my next appointment.
Gotta say, I am leaning towards the implant this time. Or, possibly, if I really wanted it and I could get prescription pain meds for the procedure, I would do Paraguard. But I really don't know.... Right now, I'm starting the mini pill...
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