Thursday, September 30, 2010

Mirena: a healthy dose of skepticism

** Warning: this post may not be suitable for kids or men or the otherwise squeamish about menstrual cycles and women's reproductive organs. **

I saw my charming Ob/Gyn at Kaiser yesterday.  They're really good in that office - started stalking me to make an appointment when their emails and postcards failed to drive me to the phone or website to do it myself.  So finally, finally, a few months over-due, I went in for my pelvic exam.

While there -- everything's fine, by the way, so far (until the labs come back) -- my doctor asked me about my periods.  As a 47-year-old woman, am I experiencing any changes worth talking about?  When I said that yes, in some ways, I felt like the first few days were somewhat out of control, he happily recommended a little IUD that would take care of that for 5 years, at the end of which, given my age, periods would likely be a thing of the past, courtesy of menopause.

The little IUD, with the fuzzy, friendly, feel-good name of Mirena, releases a small amount of progesterone directly into the uterus, which generally thins the lining of the uterus, resulting in very light periods.  Which is the reason why my Ob was recommending it in the first place.  Instead of the first few heavy days, I would have very light days.

In fairness to Mirena, I have never been a fan of ingesting hormones.  An alternative to the IUD in my case would be taking low-dose birth control pills, but as I learned 20 years ago, my body responds to those with ocular migraines, in one case a total loss of vision for about 30 minutes.  Disconcerting and unpredictable, not the kind of thing you want when behind the wheel.  Beyond that, I just don't like the idea.  Makes me queasy.

Google "Mirena side-effects" like I did, and read about the crabbiness and mood swings, the acne and weight gain, the loss of interest in sex, the migraines.  No wonder it is effective birth control.  Honestly, if we can put a man on the moon, can we not invent a form of birth control that doesn't make a person so fat and bitchy that sex is out of the question anyway?  Oh, wait, we did: it's called vasectomy, the only way to fly.

I took the brochure my doctor handed me because his enthusiasm infected me a bit while I sat there in my paper top, open to the front, another paper drape over my legs.  Having read it though, I'm left with the same question I asked him in the office: But does it come with WiFi?  Because if it did, that alone might change my mind.

Without it, no way, not a chance.  I'll keep buying the tampons, thanks, and finding a way to celebrate the last throes of my menstrual cycle for as long as it lasts. I'll continue being surprised every month, by my body (really, this is how it is now?) and my mind (really, how did I manage to forget tampons again?).

For as long as it lasts, I'll deal with it.  Sorry, Mirena: no dice.


Sheila said...

I was on the pill for 20+ years. My doctor had recommended the IUD and I had been very hesitant. A year later she recommended again when I commented on decreased desire. Here we are 10 months later and I LOVE it. So happy I made the switch from BCP to the Mirena. I can say not just low flow... no flow at all. I haven't experienced any noticeable side effects.

alicia said...

Awesome blog, Ariane. Very timely for me as my own body is starting to surprise and entertain me with more regularity now at 37?! And I totally appreciate the decision you made, but as someone who works in the 'biz' I thought I should just point out that many (or all) of those side effects may never happen to you. The main thing to look for is 'incidence' of those side effects. If 'weight gain' is 5% in the drug group, but the placebo-takers had a 2% occurrence, then you most likely will never have that side effect because the delta is so small. (I am probably stating the obvious to you, as you are a very informed consumer, but just in case you aren't fully aware of how drugs are studied and labeled, then I'd be happy to help illuminate that for you! Sadly, I know WAY more about all that then I'd care to if it wasn't my job!)

Ariane said...

Thanks for reading and for your comments, Sheila and Alicia! I am glad it's working for you, Sheila, and glad of the additional info on side effect incidence, Alicia. I do realize, too, that it's mostly the negative that shows up on the interwebs about drugs. When I had my six-month-long experience of interferon+ribavirin for hepatitis C, I stopped reading the bulletin boards, etc., since it was all misery and woe, so much worse than what I went through and so fundamentally unhelpful.

Still, since I wouldn't be getting the IUD for birth control purposes, I don't think I'm willing to take on the hormones, even at low dose, or risk (more) weight gain in my old age. Perhaps that's vain, but it's not like the tampon purchases are going to put me on the street. ;>

And pretty soon I'll just get to complain about menopause instead!