The First Rule of Birth Control

Birth control is magic.  A feminist revolution in a pill.  It’s just not my magic.


…When I have reached
into myself, and glistened out the dome,
I search its planetarium sky
for its weather, ivory nimbus, reach
of summer showers—these are the heavens
under which the grateful bodies
went to earth, dense with contentment…

– Sharon Olds, from “Diaphragm Aria”


99% effective.  To a perfectionist, these words are music.  The clouds opening up and angels coming down with a tray of 30 pink and white pills.

Let me say this up front: Women controlling their own uteruses is a beautiful thing.  The ability to control mind-numbing pain and irregular bleeding is a miracle. 

It’s just…not a miracle that works for me.

And that’s okay.

My first foray with the pill came at a perfectly reasonable time.  I was getting married, and we didn’t want kids right out of the gate.  We had a plan.

Also…I was maybe worried that, by a stupid miscalculation on my part, my period would fall on our honeymoon.  Or—worse yet—our wedding day.

(Spoiler: This was a dumb thing to worry about.)

So, I asked my OB-GYN about a pill I’d heard of that spaces your period out every three months.  She saw no reason I shouldn’t try it and prescribed it right away.

Thus began a…complicated journey.

Growing up, my relationship with my period was one of well-paired roommates.  Not particularly close, but we never fought, and each of us pulled our weight on the chore chart.  It was regular as clockwork.  Always four or five days long.  Predictably heavy or light. Only uncomfortable for one day out of the five.  Just standard cramps and bloating.  Nothing a Midol couldn’t handle.

Nevertheless, I didn’t mind the idea of skipping it.  I’d read the literature.  There was no medical necessity for a woman to menstruate.  Why do something unnecessary?

My first month, I had irregular spotting for the first time in my life.  I was expecting this.  My OB had warned me.  I wasn’t even surprised when I still got my period the first month (which was supposed to be one of the “skipped” months) since I knew it would take time for the hormones in the pills to balance out in my system.

What did surprise me was that my period felt like getting kicked by a horse.  More pain than womanhood had ever dealt me.  I limped to work and spent my evenings writhing around the floor of my condo, trying to drape myself over things in any position that might make me more comfortable.  On top of that, I bled more than usual, and unpredictably.

But I was a trooper.  I figured, this is just the first month.  Surely it gets better. 

This is magic, after all…right?

The pain did lessen after a few months, but the spotting continued.  My periods were a little more unpredictable than before, but they got less heavy, and eventually started to follow the every-three-months schedule.

I gained a good bit of weight, even though my doctor assured me that was rarely the case on the pill.  I developed digestive problems which were later diagnosed as IBS and lactose intolerance.  I can’t really say that was a result of the pill, as I can’t find any evidence of a connection (besides the negligible amount of lactose used as a filler in birth control pills), but it happened at the same time I started the pills, so I figure it’s worth mentioning.  I felt terrible most of the time.

The primary effect of missing periods was, honestly, to make me a little uneasy.  They’d always been there, since I was eleven years-old.  Their absence was like coming home from college to find all the pictures of a particular relative missing from the walls at your parents’ house.  You see the unfaded squares of paint on the wall and wonder…why?

This was the beginning of my monthly obsession: Was I pregnant? 

It started small.  Joking comments to my husband.  Sometimes even my every-three-months period was really light.  I’d had friends who experienced surprise pregnancies while on birth control.  There is that remaining 1% after all.  I started to wonder…how would I know?

I bought a lot of discount drug store tests, that’s how.  I didn’t feel like my silly obsession warranted the expensive, super-accurate tests.

It’s not like it would have been a big deal, if I had gotten pregnant.  We were always financially stable.  My husband’s bachelor pad was kind of small, but people have dealt with worse.

I was just…consumed by the thought.  I blamed it on the potential for user-error in the pill.  I thought I wasn’t taking it at exactly the right time every day, so I might be screwing up its effectiveness.  Thinking about it every night before bed was exhausting.  My sleep started to suffer, but I blamed that on job stress.

I got a new OB when I moved to the city where my husband lived, after getting married, and eventually I took this complaint to her, along with my weight gain, digestive symptoms and spotting.  She didn’t seem convinced that the digestive problems or weight gain were related, but she understood the annoyance of taking a pill every day. 

She suggested Nuvaring, a little plastic ring inserted in the vagina that releases hormones slowly over the course of a month.  She showed me a sample.  It looked innocuous.  Fun, even.  She explained how to put it in and take it out.  It was a little fiddly, but it didn’t seem hard.  And I’d only have to deal with it one week every month.

It would completely eliminate the daily hassle.  My periods would be monthly again.  She thought the constant, low-grade hormones would stop the spotting.  She even noted that, since it wasn’t oral, if the pill were having some digestive effects, this might get rid of that problem.

I was sold.  She gave me a sample.

I was proud to be on the cutting edge of medicine.  Nuvaring was the future.  A feminist miracle that you didn’t even have to think about!

But things got weird.

Even without my daily pill to worry about…I didn’t stop worrying.  I was still obsessed with whether or not I was pregnant.  I told myself I was being immature.  I knew how biology worked.  It was incredibly unlikely.

It didn’t help that my periods, while monthly, were extremely light.  Maybe a day or two with barely any output at all.  Was it…too light, I asked myself?  I took more tests.  I worried that the hormones in my birth control would skew the test results.

I wondered…what was wrong with me?

Then scarier things started happening. 

I couldn’t go to sleep at night.  I would just think the same thoughts over and over.  Back turned to my husband in bed, I’d cry for no reason.

Every time my husband and I had a serious discussion, I wound up sobbing.  Sometimes screaming. 

I cried when we discussed the grocery list.

I wondered if he didn’t love me.  If our marriage was ending.  If I could love anyone.

Slowly, my motivation was stripped away.  I came home and slept on the couch or binged Netflix.  I never wrote anything.  I could barely finish a thirty minute online yoga video without wandering off.  I ignored chores.  I cast off countless unfinished craft projects.  I couldn’t focus enough to read a book.  No matter what I was doing, I felt guilty about not doing something else.  I dreaded work.  I dreaded social situations.

I dreaded waking up every day.

I finally got a General Practitioner in my new city.  The office structure involved Nurse Practitioners taking most appointments, with the doctor overseeing patient care and prescribing medication.  I immediately clicked with my Nurse Practitioner.  My appointments were unrushed.  I didn’t feel like I was wasting her time with my arm-long list of symptoms.  I talked to her about my digestive problems.  I timidly brought up my depression and anxiety.  She didn’t dismiss any of my symptoms.  Instead of immediately prescribing medication, she made some very helpful dietary suggestions and recommended a probiotic.

This slowly but surely worked wonders for my gut.  But my anxieties and motivation problems continued to control my daily life, hacking away at my self-worth. 

More time passed, and my paranoia naturally gave birth to a certain amount of hypochondria.  I started googling combinations of my symptoms, certain I had stomach cancer or blood clots in my brain from the Nuvaring. 

One night, huddled under the comforter to hide the light of my phone, I searched for “Nuvaring anxiety.”  I was blown away.  Over and over again, forum posts, Yahoo Answers, and WebMD queries described the condition of my mental health in minute detail.

“Nuvaring almost destroyed my marriage!”

“I became a different person!”

“I was so anxious I couldn’t function!”

It clicked.  Maybe there was a reason for my madness.

I booked an appointment with my GP and another with a new OBGYN.  I explained how my anxiety and depression had ramped up over the time I’d been using hormonal birth control.  My paranoia and inability to finish projects, or sometimes even start them.  I explained what I’d read in my internet research.

I waited for them to shake their heads and tell me to stop googling my symptoms.

They didn’t.

They both nodded and said it made perfect sense for me to go off Nuvaring.  They explained my other birth control options, but also didn’t judge me when I chose to ditch the hormonal methods entirely. 

They didn’t tell me I was crazy.

My symptoms were real.

The alternative method I chose to use was a diaphragm, which got a bit of a raised eyebrow from my OBGYN, but she was happy to measure me for one.  It may seem old fashioned and uncommon in this day and age, but they still exist, and for me, this is what taking control of my body looks like.  It takes a little time to get used to putting it in and taking it out, but I like that I’m still in charge of my own contraception, minus the hormones.

In the months after taking out the ring for the last time, it was like a fog lifted from my brain.  I could see situations more clearly.  Situations that, weeks ago, would have sent me into an indecisive spiral seemed perfectly manageable. 

I had serious conversations with my husband that didn’t end in tears. 

Things were funny again. 

I picked up books.

I made plans with friends.

I wrote!

I no longer obsessed about pregnancy.

I honestly felt relieved when my period went back to being it’s old nonchalant roommate self again.

In the end, I did start taking a low dose of Lexapro, just to completely level out my moods, but just stopping Nuvaring made a marked difference in my mental state.  I do feel anxious and depressed now and again, but I never get so anxious I can’t sleep, or fall into such a deep dark hole that I want to melt into my living room couch.

This is not a scree against hormonal birth control as a whole.  Again, I love what birth control offers women.  I just feel like there must be others like me, who don’t understand why the magic isn’t working for them.  Who feel like no one is experiencing the same things they are.  Who just want to be told they’re not crazy.

There are women with these problems who want to feel seen and heard and believed.

If that sounds like you, know this:

I see you.

I hear you.

I believe you.

The first rule of birth control is…TALK about birth control! 

All the positives, negatives, side-effects, horror/miracle stories.  Just TALK about it.  Be the voice in the darkness that someone else hears. 

– Ceridwen

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