11 February 2012
women's wisdom
The last time I wrote about fertility, I was marking the six month celebration since stopping hormonal birth control. I am so happy I did that when I did.
6 weeks later, one Whole-30 and one Microbiology class (almost) down, quite a bit has happened in my life with regards to reproductive health and fertility.
At my Well Woman exam a few weeks ago, I requested bloodwork to check my hormone levels. All levels are normal! The only point of note is my total testosterone is at the highest end within the "normal" range. The doctor said she could not give me a diagnosis of PCOS unless I got a pelvic ultrasound and was positive for ovarian cysts. My hormone levels do not "qualify" for a PCOS diagnosis. Yay! Despite this, I'm not happy with the OBGYN I've seen for my last two Well Woman exams - at this past appointment she didn't reviewed my chart before coming in, didn't remember or know anything about my history or previous lab results, and her offices requires patients to call them for lab results - 2 of my 4 calls they didn't return. I'm going to switch to a DO or holistic doctor for next year.
After using condoms for six months while I hoped my cycle would normalize, I discovered cervical caps, and since they are effective, reversible, non-hormonal and don't require a medical procedure, I thought they might be the answer. We acquired one without a prescription through the Canadian website Lady to Baby, but it wasn't cheap. Over $100 for a cap and nonoxynol 9-free spermicide. I had read all about insertion and removal before I got it, but I still studied the instruction sheet, practiced inserting it several times - I even left it in while I went to the gym to see if it moved around. When getting my exam, I asked my gynecologist to check that it was the right size and fit my cervix completely. It did - green light. So, we tried it. Three times. 2 of the 3 times, it dislodged and exposed my cervix. BIG FAIL. (Backup was in place). Only once did it stay on as intended, but in certain angles, I could feel it and it was unpleasant. So, after three attempts - two terrible and one just okay - we abandoned the (expensive) FemCap. I wanted to love it, I really did. I had read that women liked it, their partners couldn't feel it, and it lasted for several years. But it didn't work for us. And frankly, it's nice not having to think about a small object inside me that must stay in a certain position or else... trouble.
My cycles are still irregular. I'm not disheartened by this - it's still only been 7.5 months since I stopped HBC and it can take years (plural) for some women's cycles to regulate themselves after hormones. I wouldn't be surprised if I'm one of those women. I also wouldn't be surprised if I just have irregular cycles, even with clean eating and adequate sleep. The final BC option (that is non-hormonal, very effective and doesn't require putting something on or in one of us each time) is an IUD - the non-hormonal brand (Paragard). I called my OBGYN and was told it would cost $550 for the device alone, not including insertion. That was the last nail in the coffin for that relationship. I called my local Planned Parenthood and was told that since my health insurance doesn't cover contraception and I work part-time, I might qualify for California's Family PACT program for low-income people. The device would cost $300 and another $100 for the visit, insertion and tests. $400 is still a chunk of change, but IUDs are by far the cheapest birth control method available. Paragard is effective for ten years (and Mirena, the hormonal IUD, is effective for five). Assuming I want to get pregnant around 30, an IUD's monthly cost over 6 years is only $5.50, versus $9/month for condoms or $15-40/month for prescription pills with a co-pay. When I filled out the paperwork at the clinic, they confirmed I qualified, and told me the entire procedure and device was covered by the state. I was honestly shocked - I misheard the receptionist and thought the $300 quote was with a discount. Score!
The procedure itself wasn't a bundle of fun, but it wasn't bad. It was uncomfortable during the actual going-into-the-uterus part, like dull period cramping. But manageable. (They recommended 800mg of ibuprofen prior to coming in, although the wait was so long it had mostly worn off by the time I was in stirrups.) That evening I had bad cramps - the kind where you want to down Midol and curl up on the sofa with something feel-good (I chose Friday Night Lights; I'm re-watching the series). The next day was less sore, and 24 hours later I felt fine. The procedure seemed to have induced my period (that or it was uncanny timing), but at least its been cramp-free.
I am still charting my cycles. I didn't ovulate this last cycle, although it seems that my body attempted to around Day 15 - my cervix was in the ideal position, my skin broke up in pimples, and my temp was high for three days. The software said I ovulated, but when my temps dropped below the coverline it receded its original opinion. My body may have tried to ovulate again around Day 25. Needless to say, it wasn't successful. The cycle lasted 44 days and my period only seems to have arrived thanks to the IUD insertion getting my uterus all riled up. I continue to say affirmations, although this past month they've been very short and sweet since the workload for my Microbiology class has increased drastically. The class is over next Thursday, and in the final four days of class I have two lab reports due and two exams to take. It's been a fascinating class, but I wish I had been able to take it on a regular semester schedule and have it sink in more effectively. I'm really looking forward to Friday, when I no longer have a stressful weekday schedule and can do things again, like go the gym and sleep more than 6 hours a night.