Tuesday, November 22, 2016

Why I Quit The Pill

For the longest time, women have felt like they have to keep their menstrual and reproductive health problems secret, for fear of offending male ears or disgusting their coworkers. Personally, I never felt comfortable talking about the problems I experienced on birth control with anyone but my doctor. (Thanks, period stigma!) But I also don't think that menstruation or reproductive health should have to be a secret. 

Lately, it feels like there's been a bit of a revolution against hormonal birth control. I became part of that revolution back in August, when my doctor urged me to quit taking birth control for health reasons. Around that time, I was seeing a ton of articles on Pinterest and elsewhere explaining how the hormones in birth control pills could cause a host of problems, ranging from low sex drive to depression (both of which I experienced on birth control).

Lots of women nowadays are fighting back against the common assertion that the birth control pill, or any other form of hormonal birth control, is the best or only choice for anyone.

Over the summer, as I became more and more fascinated by women's health topics, I even read a book about endometriosis, that challenged the common use of birth control pills as a long-term treatment option. It's not just another natural health phenomenon propagated by the fitness industry. Even the medical community is fighting back.

While it's true that I quit birth control pills amidst this medical revolution, I would also like to add that there's nothing wrong with using birth control pills or other hormonal birth control. If you don't experience any negative side effects on the pill, you shouldn't feel like you have to quit just because of something you read on the internet. Choosing to start (or stop) a birth control method is a personal choice every woman should make on her own. 

However, I know that a lot of women are probably asking themselves, "Why all this fuss about the pill?" Before my health problems developed, I probably would never have thought twice about my choice of birth control.

I may not be able to speak for every woman who has denounced the pill, but I can certainly say that while oral contraceptives, aka birth control pills, work great for some women, they didn't for me. 

This is the story of how and why I quit.

Why I Started the Pill

I was fifteen when I started birth control pills. I wasn't exactly sexually active yet (that is, I wasn't having "real" sex), so that wasn't my primary reason for using it - though its birth control function did come in handy later.

The real problem was that I developed heavy, irregular periods and painful cramps about a year or two after I started my period. I got my first period when I was 11, and for the first year or so, I suffered from light, frequent periods (we're talking sometimes every two or three weeks) that didn't really bother me, aside from the near-constant cycle of bleeding. 

But around 12 or 13, something started to change. I started to get deep, throbbing aches in my lower back and abdomen. Every time I got my period, I had to dope up on Aleve just to get through the day at school. My flow also started to change as my periods started to become somewhat-more regular, becoming heavier and brighter in color. 

I grudgingly dealt with these problems until high school, accepting that a woman's period was just a burden she had to bear. But constantly needing to sit down and take a break every time you get your period, because your cramps are just so bad, eventually takes its toll on you.

As a freshman in high school, I found myself on my period, laying on the cafeteria floor at lunch with my friends because the cold linoleum felt good on my aching back. An upperclassman took a picture making fun of me and posted it on Instagram.

The following year, I took the MCAS (Massachusetts' state standardized test) for the last time. Halfway through the essay-writing portion, my cramps became so bad that I felt dizzy and nauseous. I had to excuse myself to go to the bathroom and take an Aleve because I absolutely could not concentrate. Embarrassingly enough, I explained to my teacher what was wrong, but she was nothing but sympathetic, saying that even she had noticed how bad I clearly felt.

When period cramps interfere with your life to that degree, you lose your confidence. And that's where my journey with birth control begins.

That August, I had my yearly checkup at my pediatrician's office. My mom was in an exam room a couple doors down with my little brother, who was also having his yearly physical at the time.

Unexpectedly, my mom popped into the room during my exam. I had been planning to ask my doctor about birth control pills in private, but I wasn't about to let my mom's presence change my plans. My mom later claimed to be "shocked" that I had asked for them "out of nowhere," without consulting her at all.

In all honestly, I had been too afraid to ask, because I didn't want her to think I wanted them for "the wrong reasons." My mom had me young, claiming that she had been too afraid of her parents finding out she was on birth control (see any similarities?).

My mom left me with the exact same feeling, even though all I wanted them for was to make my quality of life a little better. Even if I had wanted them because I was sexually active, there shouldn't have been anything to fear.

As a budding woman with period cramps and a (unbenownst to me at the time) mental ilness, that was my first of many experiences with societal stigma. And while stigma wasn't the ultimate reason why I had to quit birth control pills, it factored into my (voluntary) decision to take back my reproductive freedom by going off of them.

What I Experienced on Birth Control

The first two years of birth control were great. My periods became lighter and more manageable, with less pain and cramping. My cycles also became regular, whereas before they had varied from too long to too short.

Then, as a senior in high school, I broke up with my boyfriend. I met a new guy. I fell in love. And like so many other teenagers, we decided to "do it" for the first time.

Every girl's first time is more than a little awkward - and every guy's, for that matter. (Honestly, whose first time actually goes the way it was planned?)

Thankfully, I had prepared myself for awkward. I had even prepared myself for pain, though experts claim that your first time should never really hurt the way people say it does. But what I hadn't prepared myself for was just how much pain I would experience.

My boyfriend was careful and loving and kind, and our first time shouldn't have hurt. Still, it did, and I immediately put the blame on myself, feeling angry that I hadn't been turned on enough to please him.

Admittedly, it wasn't a healthy reaction to losing my virginity. But I don't think the problem was that I wasn't ready. The problem was that I wasn't expecting it to hurt that bad.

Sex seemed to get a little easier for awhile. We discovered the beauty of lube, which we had (foolishly) ignored, like most teenagers, the first time. But around Christmastime, I started to experience a new type of pain that I hadn't experienced before - a rubbing, chafing sensation. I acquired other unpleasant symptoms as well, like (TMI, probably) thick white discharge and burning pee.

I wasn't a stranger to vaginal infections, so it only made sense to assume that was what I had. At 13 years old, I'd mistakenly self-treated for a yeast infection only to find out I'd had bacterial vaginosis, a completely different animal of a vaginal infection.

This time, I recognized the yeast infection symptoms from the information on the back of the OTC-medication package from all those years ago. So, I scheduled an appointment with my doctor about a week later. She asked me a lot of questions, performed a (painful) gynecological exam using a speculum, and send samples off to the lab for testing.

In the meantime, concluding that I was probably right and most likely did have a yeast infection, she prescribed me fluconazole to treat it. The way the fluconazole worked was that I was supposed to take the pill one time only. Ideally, the single dose would be enough to rid myself of the yeast, but in case the infection decided to stubbornly hang around, she prescribed me a second dose to be taken a few days later.

I took both doses, with not much improvement to my symptoms. Shortly after, the doctor called with an explanation: I hadn't tested positive for yeast, after all. In fact, my lab tests had come back completely normal.

Christmas and New Year's both went by before I scheduled another doctor's appointment. In the meantime, my relationship with my boyfriend was starting to struggle emotionally from the sexual dysfunction I was experiencing.

The fact of the matter was that sex hurt. No matter how much lube we used, it always seemed to dry out faster than expected. Or, certain products would just sting when we applied them, causing me even more pain.

Something a lot of women don't mention when they talk about these issues is the emotional toll that it takes on a relationship. A lot of sex sessions that should have been fun, frisky, and flirtatious ended in tears. As you can imagine, the pain I experienced as a result of my vaginal problems didn't make sex very fun for me, nor were these circumstances exactly conducive to an orgasm.

At some points, I even felt so low that I believed I was "less of a woman," that I wasn't really in love with or attracted to my boyfriend, or even that I wasn't attracted to men at all. (Though there wasn't anything fundamentally wrong with me questioning my sexuality - many young people do, and many people draw the conclusion that they aren't straight, which is completely healthy, normal, and fine - in my case I found out that these were just fears, fears that resulted from a combination of my anxiety disorder and the low libido I experienced on the pill.)

On top of that, my boyfriend started to lose confidence, too. He sometimes thought it was his fault I was hurting. Because I knew it wasn't, I started to feel guilty for making him feel bad, which just led to an endless spiral of negative emotions. And because of those negative emotions, I actually think the sex hurt worse, because neither of us felt as aroused as we could have under normal, healthy conditions.

Two more painful gynecological exams later, I was pretty much just apologized to and told to try a plethora of at-home remedies.  I read online that I could try taking hot baths or painkillers before sex, so I did. I watched Laci Green's sex ed channel on YouTube and found out that certain kinds of lubricant can cause unhealthy bacteria to grow in your vagina, so we ordered special, all-natural lubricant online.

Even my doctor recommended remedies that hadn't been scientifically proven simply in the hopes of offering me relief, such as taking a probiotic supplement. Though she said there wasn't clinical evidence that it would help, she told me many women experienced some relief with the addition of the supplement, and that it would be worth a shot at any rate. I've taken a probiotic ever since then.

Only one idea offered a short-term remedy that didn't last: we quit using latex condoms, and switched to polyisoprene instead. Since quitting the pill, I've actually discovered that I have a latex sensitivity - but since that was only about 50% of the problem, it didn't provide 100% of the solution. I think the sheer belief that quitting latex condoms would solve our problems convinced us at first, but after a few weeks passed by, we realized that something much deeper was going on, a problem that couldn't simply be fixed with shiny new condoms or all-natural lubricant.

Unsurprisingly, the topic of birth control came up more than once at my appointments. I switched up my birth control prescription once or twice before realizing it did no good to replace harmful hormones with more harmful hormones, or different types of harmful hormones.

But at the time, quitting simply didn't feel like an option. To me, going off the pill meant a certain pregnancy - and neither me nor my boyfriend were ready for that, obviously. We were just two kids in high school, and the prospect of raising a baby scared us both equally.

At my third and final doctor's appointment, I was finally referred to a gynecologist (believe it or not, at seventeen years old, I had never visited one before). The referral felt like a glimmer of hope. My doctor built me up to expect the appointment to give me answers that she, as a generalist, hadn't been able to give me.

Getting into the gynecologist proved almost as difficult as the journey that had led me there. I had first tried to schedule an appointment in February or March, and hadn't been able to get in until April. Then, a cancellation had forced me to push the appointment out until June.

That time wasn't easy for our relationship. I don't care to relive it here, but I'll just say that it was full of the same tearful sexual encounters and fights as before - only now, these issues were becoming so deep-seated that they began to chip away at the previously rock-solid foundation of our relationship.

For that reason, my gynecologist's visit became even more of a holy grail. I didn't care about relieving the pain anymore so much as learning how to enjoy sex and please my partner again. But after an hour of intrusive questions about my sex life and the same gynelogical exam and swabs I'd received countless times before, I simply received a diagnosis of "vaginal dryness" and was sent on my merry way.

Sex hurt, but not as much as the disappointment of having to drive home feeling as if my problems were invisible. Even this gynecologist, the specialist who was supposed to have cured me and my relationship problems, had no answers for me. I started to wonder if I was a medical anomaly. I began to oscillate between believing that my body was fundamentally broken, or that my problems were all in my head....

In short, I lost hope.

Why I Finally Had To Quit

The last straw for me was when my birth control started to affect my mood. My physical health was already trash, but I wasn't about to let some stupid pills negatively impact my mental health.

I already had so much wrong with me physically. By that point, no doctor had offered me a solution that had worked for more than a couple of weeks - maybe a month if I was luck. At that point, I was willing and able to accept that the pain and the low sex drive were just something I might have to deal with for the rest of my life.

While I felt a deep and incommunicable sense of grief and disappointment that other girls didn't have to live this way, I understood that some people are just dealt unlucky hands in life. The way I saw it, painful sex and all these other symptoms were just my bout of bad luck.

What I wasn't willing to accept was the damage this medication eventually caused to my mood. It just so happened that I was in the middle of battling a second beast when these physical problems arose: my mental illnesses.

Anxiety had become so deeply ingrained in who I was that I had simply accepted it as a personality trait. My mom tells countless stories of my neuroticism and perfectionism from my childhood that seem funny to her, but to me just seem like hallmarks of my developing disorders.

I was depressed for the first time when I was a sophomore in high school. On top of that, I had intrusive thoughts about suicide that confused and frightened me. I knew in my heart that I didn't want to die, but the thoughts - as so many obsessive thoughts do - popped into my head every time I saw a bottle of pills or a pair of scissors. I didn't know yet that those thoughts were symptoms of my obsessive-compulsive tendencies (my therapist's term for my OCD-like symptoms, which aren't quite enough to warrant a diagnosis but certainly deserve recognition nonetheless).

It actually wasn't until I finally started to open up to my boyfriend about my feelings that he suggested I had reason for concern. He told me that I should ask my parents to see a therapist, which had never crossed my mind before.

At first, we fought every time we talked about the idea. My anxiety made me less than receptive to the idea of opening up to my parents about my feelings, especially because my dad's anxiety became a sore spot in my divorced parents' relationship toward the bitter end. But in the end, I am forever grateful to him for bringing up the subject. Without him, therapy would never have been on my radar, and I wouldn't be where I am now, feeling healthier than I ever have.

I finally started to feel like I could make progress toward getting better. I'd resolved to talk to my mom about therapy, or seek treatment on my own once I became an adult. I was devoting more and more time to self-care practices despite my busy schedule; I started to take baths, write in my journal, and color in mindfulness coloring books. I also read self-help books and pinned mental health articles on Pinterest like nobody's business. My untreated anxiety and depression even became the subject of my second blog, Love, Haley.

And for maybe the first time in my high school career, I didn't do these things because they were productive or would help me get into college, but because they made me happy and I enjoyed them.

Things had finally started to look up for me - until they took a dramatic turn for the worse. The summer before I went to college, just a few short months ago, I entered my third or fourth depressive episode since I was fifteen.

The mental strife, and the strain on my personal relationships, that my depression placed on me opened my eyes to the potential role that birth control may have played in all of my health problems. Around the same time, I started to see articles cropping up around the web that blamed birth control for negative side effects much like the ones I'd experienced: low libido, vaginal dryness, painful sex, anxiety, panic attacks, and depression.

My mental health problems were simply too much for me to deal with. I was desperate for a solution, and if birth control pills were to blame, I wanted them out of my life forever.

In August, I scheduled a physical for my freshman college paperwork. At the appointment, I finally took a bold risk by addressing the mental illness I'd tried so hard for so long to conceal. Subtly, I suggested that I thought birth control might have been linked to my symptoms, so my doctor gave me a questionnaire that tested for anxiety and depression using a numerical scoring system.

Silently, I filled out the survey as honestly, as vulnerably, as I could. Then, I handed it back to her. She tallied my answers, then looked up at me with a serious expression.

I'll never forget what she said to me: "These scores cannot stay this high."

Hearing those words, a glimmer of the hope I'd lost finally returned. Having someone validate your emotions always feels amazing - but the best part was that she acknowledged that my birth control might have been doing this to me.

It wasn't all in my head; I wasn't crazy; I wasn't any less of a woman. I was normal, 18-year-old girl whose medication was making her sick. And so on my doctor's advice, I decided to talk to my boyfriend about quitting the pill.

Why It's So Important To Talk About Birth Control

The narrative of the medical drama I experienced last year contains innumerable examples of stigma. Throughout my birth control journey, I felt ashamed of my body, my health, and my womanhood.

I didn't know how to talk about my problems with my friends, my mom, or even my doctor, sometimes. I constantly felt like I wasn't explaining myself properly, or that other people weren't listening. I also consistently downplayed the amount of pain I had, and what my symptoms were, in order to avoid telling my parents that I wasn't a virgin anymore.

My fear of slut-shaming, and of being punished for having sex, forced me into silence about a very real medical problems I was having. Personally, I feel that this is inherently wrong.

The worst part about stigma, especially when it comes to medical issues, is that it makes us reluctant to talk about what's bothering us, which then makes our problems more difficult to treat. Imagine trying to explain that you hurt your arm without using the word "arm." That's basically how it feels to go to the gynecologist, when you grew up believing that "vagina" was a dirty word - a swear only suitable for porn movies and Amy Schumer skits.

During that year, I learned more about sex, birth control, and my vagina - that's right; I am no longer afraid to say it - than I ever knew before. My school didn't have sex ed, and my parents didn't give me 'the talk,' so when it came to sex, I was on my own. The only thing I knew was that if they found out I was doing it, they probably wouldn't be happy. Not only did I suffer in secret, but I also suffered with very little information available to me. The little information I did have came from my doctor or the Internet.

One important thing I learned in my research? Going off birth control doesn't automatically mean you will get pregnant.

I shouldn't have put up with the physical pain my birth control caused me as long as I did - but for me, the fear of getting pregnant was too great. I had a college scholarship; a bright future ahead of me. Getting pregnant simply wasn't an option, so it wasn't until I began to fear for my mental well-being that I started to realize just how poorly my birth control was treating me.

When I first thought about quitting birth control, getting pregnant felt unavoidable. Unless I replaced it with another hormonal method, like an IUD or an implant, I thought the chances of pregnancy off birth control were much higher than they actually are. Thanks to what I'd seen on TV (since that was pretty much all the sex ed I'd gotten), I was certain that all condoms would inevitably break, and that without a back-up birth control method, I would be doomed.

It wasn't until my doctor told me that condoms, when used correctly, can be just as effective as the pill that I felt comfortable even entertaining the possibility of quitting. Even then, the idea still scared me. Some days, it still does scare me, knowing that someday I could need to take Plan B or even have an abortion - but I feel much more comfortable in my decision now that I have so much more information available to me about different birth control methods, and how my prior birth control method affected my health.

Stigma surrounding my health issues affected the other people in my life, too - not just me. When my boyfriend told his mom he was bringing me to the gynecologist, her first question was an angry "Is she pregnant?" Once he explained what was going on, his mom then turned to wondering in fury why my own mother couldn't take me.

In actuality, it wasn't my mom's fault. It was mine. I wasn't comfortable asking for company, or even having anyone else in the room when I got my exam.

But ultimately, the hardest part of adjusting to my life after birth control wasn't the heavy periods or the cramps, neither of which were as bad as I remembered them. Instead, the greatest challenge I faced was getting my boyfriend to hop on board.

He'd had about the same sexual education that I had, relying on the Internet and porn, and didn't know much of anything about birth control methods. All he knew was that he wanted me on one. For him, getting me pregnant wasn't an option either, as we were both students with our own career goals and paths - but as grateful as I am that he wanted to take precautions against pregnancy, I found myself frustrated as I tried to explain that condoms were just as effective as other forms of birth control.

You see, we weren't always as responsible as we should have been about using condoms when I had been on the pill. Like many men, my boyfriend thought that it "felt better" without one. So did I, because not using a condom had eased some of the pain I had previously been feeling.

When we first started to argue about it, I thought it was my fault for giving him expectations, and for "letting him" have sex without one in the first place. I thought I had set an unhealthy, damaging precedent, when in reality, I had the full right to change the sex rules - and to be comfortable with them - whenever and however I wanted.

After a few days of debate, I finally got through to the real root of his concerns, which wasn't really that sex "felt better" without a condom, but that he still felt uncomfortable without a backup method of birth control. He urged me to try a copper IUD, the only non-hormonal IUD on the market, but I said no because I wasn't comfortable with the risks associated with it.

In the end, I found that the problem wasn't getting him to agree with me, but educating him on the issues. As a guy, he hadn't been taught (or done research on) any information about birth control. As a guy, who doesn't have the birth control options that women do, he never had any reason to.

Put simply, my boyfriend didn't know the facts. He didn't know the risks associated with IUDs, or the efficacy rate of condoms. Once I explained those things to him, he gradually began to come around to seeing things my way, and learned to accept my decision.

It wasn't that my boyfriend was an asshole or wanted to dictate my birth control choices - it was that he just didn't have all the facts necessary to making educated decisions. Once he was given the information that I had, my boyfriend slowly began to understand why my birth control wasn't a good fit for me. Now, we are both comfortable with my choice and enjoy sex much more, since my libido is higher and sex doesn't leave me in excruciating pain.

In that sense, my boyfriend, too, became a victim of women's health stigma. Men have the right to know these things as much as women do. Educating men helps them be better, more understanding partners. We might assume that they don't care or don't need to know, or will try to meddle in our personal health decisions - but in reality, many men are happy and willing to learn these things, if they are only given the opportunity.

My health issues gave my boyfriend the opportunity to learn - something not every man gets in his lifetime. That's why we need comprehensive sexual education for both sexes, about both sexes.

Stigma is a drain on everyone, and over the course of last year, it drained me. I was constantly exhausted from fighting a war with my mind and body. Now, without birth control, I am free in more ways than just one. I am both free of pain - mental and physical - and free of the stigma that society imposed on me.

If there's anything you take away from this blog post, it's not that you should quit birth control. That's not my message. My message, put simply, is educate yourself. You deserve all of the information available to you about what birth control methods are right for you, and how they might be impacting your health. Don't let your parents, your sex ed teacher, or your conservative neighbor hold you back!

Your health is your responsibility. You cannot rely on anyone else to take care of it for you. If you want to feel better, then "vagina" cannot be a dirty word. Sex cannot be a sin, or something reserved for sluts. You cannot be afraid to speak up, and tell a doctor when something is wrong with your body.

Stigma is real. It's real, and it hurts. We all face it every day, regardless of our gender. But the good news is that we can fight it, and that's what I ask you to do today.

I hope I have succeeded in changing your perceptions about birth control. I hope I have challenged your beliefs and the way you think about your body. Most of all, to anyone who has struggled the way that I have, I hope I give you hope.

Help break the stigma! Share your period or birth control story in the comments below.

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