I will never forget the horror of my fifth grade classmate opening up a coin-purse that was hanging out of my backpack and stuffed with maxi pads while we were waiting for class dismissal. Luckily, he had two older sisters and quickly recognized the contents, so nothing much happened other than him quickly shoving it back into my bag and us both turning bright red. I can’t even remember his name at this point but I do recall every inch of my body burning and sweating with hot embarrassment.
A year and a half later, I was still the only middle school girl I knew with her period. Outside of my immediate friend group, I pretended I also hadn’t gotten mine yet. But the secret didn’t last long; my cycle was immature and irregular, and by the time I was in 7th grade, I’d already bled through my shorts onto school chairs and ruined my friends’ sheets at a sleepovers. This all came to a frenzied, frantic, and truly humiliating peak when I passed out during a P.E. class during my cycle from blood loss.
That was my entry into a different kind of womanhood; not the biological or physiological kind, of which I had no control over, but the deeper, more exhausting womanhood in which most of our days are taken up by remembering exactly how annoying it is to be a woman and trying to prepare for it as best as possible. And it sucked. It sucked so bad, that by the time I made it to the the gynecologist for the first time post-P.E.-incident, I was excited to be poked and prodded. I just wanted answers.
The Pill, I was told, was my answer. My mom and I pushed it off for as long as we could, but at age 14, right before Christmas break of eighth grade, I decided I was ready to end this bleeding bullshit once and for all. And just by taking one measly pill a day? Psht. Easy.
Thus began my very long, very complicated, and very NOT easy history with birth control.
I was on one pill for 11 months before I realized it made me gain 25 pounds. Nothing had changed in my diet and I was more active than ever, so it really caught me by surprise when my cheerleading uniform grew tighter and tighter, eventually not zipping up at all. I was furious.
The next pill I tried turned me into a moody bitch, far and above the normal moodiness and bitchiness of teenagers. It was so bad, I bet if you asked everyone in my family “at what point was Sarah just the absolute worst?” they would all pinpoint ages 15-16. And they would be right, because those were the years of Ortho TriCyclen.
At 16, I had gotten into a serious relationship and was considering having sex. My mother, the saint that she is, was understanding but justifiably concerned that I couldn’t yet grasp the ramifications and risks of that decision. From her, I now understood that birth control was about much more than controlling my batshit period, and I started to pay more attention to what the people around me were using for protection. That’s when I first heard of the birth control shot, Depo Provera. Once a month shots that are more effective than the pill? Hell yeah – I was sold.
But alas, two days before I was scheduled to go in for my first shot, I overheard an older volleyball teammate describing the endless hell Depo shots had put her through and decided to cancel my appointment at the last minute. Still, I knew I couldn’t stay on my raging-bitch-in-a-bottle pill much longer, so I rescheduled an evaluation for a few months later.
The next pill I went on took away my period completely, all the way up until I stopped taking it. A year or two earlier, the idea that a pill could take away my periods would have been a welcome revelation. But now I was sexually active, and missing my period month after month was stressful and exhausting to the point that I didn’t even want to have sex anymore. (Now that I type this out for the first time, I am realizing that maybe that was my doctor’s plan all along, ha!)
Fast forward to college. I was 18, I’d been taking birth control for 4 straight years, and since my my boyfriend and I had broken up earlier that summer, I decided to take my first break from the pill. I don’t want to sound dramatic here, but it was like clouds suddenly parted and a fucking gospel choir descended from the sky singing impassioned HALLELUJAHS. I felt, for the first time in years, normal. And that was definitely not normal for me.
I waited for my first period off the pill with utter dread. To my surprise, it arrived late but quietly, and finished quickly. I didn’t get my hopes up at first, but after a few months of this, it was clear my bleeding disorder had sorted itself out and I didn’t need to be on the pill if I didn’t want to be.
A year later, I was on spring break at my family’s house in Turks and Caicos with some friends and my future husband when I felt extreme pain in my lower abdomen. Sharp to the point of taking my breath away, eventually the pain subsided into rolling localized cramps that inspired 3 hours spent googling descriptions of appendicitis.
Two days later, the stinging and cramping pains were still there, so we flew home early so I could get to the doctor. After an ultrasound, I was presented with imagery showing I had two ovarian cysts. One, the size of a clementine, had ruptured, and that’s what was causing so much pain. The other, this one the size of a large grapefruit, was fully intact and would eventually rupture too. Hormonal birth control, they told me, could help regulate my hormones and decrease the likelihood of more ovarian cysts in the future. Still throbbing in pain, I agreed to consider the pill again.
Except this time, there were a handful of new options that didn’t exist before: the Nuvaring, the Paragard IUD, and the implant. I didn’t know where to start, but my doctor liked the Nuvaring for me since I was clearly very sensitive to hormones and I’d already tried all the low dose pills on the market. Nuvaring, he said, would keep the hormone dosage lower and a little bit more localized.
To be honest, I loved the Nuvaring at first. It was a simple concept and it was comforting to know that I couldn’t screw it up since I didn’t have to remember to take a pill each day. It wasn’t until months later when I was backpacking across Southeast Asia and experienced my first panic attack that I had concerns.
At first I suspected it was my lifestyle. I was a classic 22-year-old: perpetually hungover and running on too little sleep with too much Vyvanse/Adderall. So, I cleaned up my act. I cut out gluten and sugar. I logged at least 8 hours of sleep at night. I gave up alcohol, red meat, and caffeine. But my anxiety only got worse, culminating in what would end up being a life-altering year filled with ER and psychiatrist visits and clinical depression and panic disorder diagnoses.
To be clear, I do not believe Nuvaring caused my mental health issues. It was a long journey during which we discovered other issues that were diagnosed and treated. I do, however, believe that Nuvaring contributed to my decline and I know for certain that I felt lightyears better very soon after I stopped using it.
That brings us to nearly the end of my hormonal birth control saga.
Enter: the IUD. I was either incredibly naive or incredibly indoctrinated, because in 2015 I went to my OBGYN to ask to get back on birth control again. My plan was to stay away from hormones by having the copper IUD inserted, but my doctor told me that with my history of heavy bleeding, the the Mirena IUD would make better sense. “Better yet,” he said, “let’s get you started with Skyla, Mirena’s smaller, lighter-dose little sister. That will be better for you.”
I scheduled my Skyla appointment for the following month and, after what was a truly horrendous insertion experience, felt pretty good about my decision. Then about two months later, I realized I’d had this nagging cramp in my lower back that had flared up during the insertion and hadn’t gone back down. When I brought it up to my doctor six months post-insertion, he told me he had never heard of that happening, which was odd, because a quick Google search told me many women had experienced the same thing.
If it had only been the back pain, I probably would have kept the Skyla for longer. Unfortunately, my skin exploded into cystic acne (which took almost three years to get rid of ) and I experienced near-constant cervical cramping for the next 1.5 years. Sitting in a meeting, on MARTA, riding a bike, walking to the park – it didn’t matter where I was or what I was doing, every 20 or so minutes, I’d feel a sharp stinging cramp right at the base of my cervix, which I can only describe in my childless world as the closest thing I can imagine to a contraction. For 1.5 years! The second I had the IUD removed, my back cramp dissolved and my cervical cramps were relegated back to my period where they belonged.
That brings us to the end of 2015, when I started searching for natural methods of birth control. As with everything I do, performance and efficacy are paramount, but given the nature of birth control, I was even more particular about finding an option that would work for me with solid data to back up its efficacy stats. I pored over study after study after study and learned an insane amount of information about all sorts natural birth control methods before I settled on one the one that I still practice today, nearly 4 years later, with zero side effects.
But that’s another story for another day. Stay tuned for Part II.
