See, I told you I wasn’t abandoning the #Periodically blogs for Pleasure Moans. I’m back here because despite the pill, the endometriosis diagnosis and pelvic physio my pain is still interrupting my daily life and even recently made me pass out while watching a performance of Henry IV Part One, so I desperately need a more long-term, semi-permanent solution, or at least an attempt at a solution, that doesn’t immediately involve more surgery. So, I’ve had a Mirena coil/IUS installed in my uterus.
I’ve spent a lot of time on the #Periodically blogs discussing my complicated feelings towards hormonal contraception – the broader culture of those discussions is actually the subject of my masters dissertation. Even though the process from second surgery to coil insertion was pretty quick (about three months), it was not a decision I took lightly. Yet my feelings remain much the same as when I wrote about going back on the pill, in that I am deliberately trying to mess with my cycle to improve my pain.
Anyway. Before the surgery I was already coming around to the idea of having a Mirena coil fitted in the event that endometriosis was found. A Mirena coil is an intrauterine system (IUS) that sits at the bottom of the womb – it has two strings that pass through the cervix so you can check it is still in place. Mirena releases an artificial progesterone, Levonorgestrel, to thicken cervical mucus to slow sperm down, to (sometimes) stop ovulation and most importantly for me, it thins the lining of the womb. It lasts for five years. It’s used to help people with endometriosis because by thinning the lining of the womb, and potentially stopping periods altogether, it stops those patches of missed-placed endometrium-like tissue from building up and causing trouble. It’s not a cure, but the hope is that by stopping my periods for a few years then it might turn endo off for a little while too.
This is a big deal for me. I’ve spoken in great detail about how, despite everything, I’m actually quite fond of periods, but I’ve weighed all the pros and cons and the Mirena coil still seemed like the best idea for now (plus let’s be honest, my body probably won’t actually do as it’s told and stop bleeding). My gynaecologist told me to expect six months of sporadic bleeding and pain, but a six month blip of increased pain for potentially four and a half years of relief seems like a reasonable (hmm) trade off. Both my gynae and my GP encouraged me to stay on the pill for the first two months of the coil to try and make the transition a bit smoother. I was pretty resistant to this idea, not wanting to make my skin or mood any worse by increasing my progesterone dosage, but after talking to people who did so successfully I’ve followed their advice.
Once I made the decision, however, I had to acknowledge the fact that fitting it was not going to be easy. Ideally it would have been fitted while I was under for the laparoscopy in April, but because my surgeon was so convinced it wasn’t going to be endo he didn’t do the consent form for it. When I saw him for my post-op he thought it possible I might have to be put unconscious in order to fit it. I desperately wanted to avoid another general anaesthetic so soon after the last, but evidently a pelvic floor dysfunction that makes any kind of vaginal penetration incredibly painful and/or impossible, meant it was on the cards.
The doctor in charge of IUS insertion at my local surgery was a new doctor to me, which made me a little wary but thankfully she was lovely. I explained my experience with painful (and frankly unsuccessful) pelvic examinations and sex and my motivations for getting a coil in the first place. She was super understanding and came up with an action plan: I would take some diazepam an hour before the insertion to try and relax my pelvic floor. If my body was still uncooperative she would not force the issue. I was to take the day off and have someone accompany me to and from the appointment.
Well, as the beginning of this blog gives away, the coil was fitted but it was twice as complicated and a hell of a lot more painful that I expected it to be. The doctor decided to use an anaesthetic gel, but that didn’t seem to provide much relief. Both she and the nurse were really supportive throughout but honestly it was a little traumatic. Even though it all happened quickly, we had to try various different tactics, positions and speculums. I wish I could say it was fine and just a little uncomfortable but it was a 10/10 for pain, which felt something akin to my cervix being stapled. It seemed like I might vomit and/or pass out and so I was given some water and told to take my time. Thankfully this pain didn’t last long but it was immediately replaced by hot, heavy cramping. Excellent!
A man clearly made up the post-coil insertion rules because while tampons were off the cards, sex was not, apparently. The doctor advised me to use condoms for a week, at which point I reminded her of what had just happened and why – sex is not on my radar at the moment.
It’s been about 10 days since the insertion and the pain is still very intense. Weirdly, it’s mostly been awful period cramps all morning every morning, resulting in copious amounts of ibuprofen and co-codamol and many hot water bottles, but in the afternoon it settles and I’m more-or-less OK. The last few days have also involved some excruciating vaginal pain, so that’s new. I have hardly bled since, but I’m expecting that to hit when I come off the pill in a few weeks. As much as I’m hoping the transition period might be shorter than six months, I’m not holding my breath.
I am excited though. Mostly at the prospect of long-term relief in the future but also at the possibility that coming off the pill might mean my acne improves. The hormones in the Mirena are localised to the pelvic area, meaning there’s a chance it won’t affect my skin in the same way a systemic approach like the pill does. I’m trying not to get my hopes up about this silver lining but honestly when I think about it I squeal with excitement.
Since it was so painful I didn’t want to throw yet another horror story out into the world, but a few people have asked for details so there we go. I think the fact I had it fitted during a particularly lengthy flare-up was both a blessing and curse. Already being in pain meant I was motivated for relief and so I didn’t chicken out but it also means I haven’t had a break from pain in weeks which is exhausting and definitely messes with your head. Nevertheless, I’m trying to keep in mind something I wrote in my diary a few hours after it was inserted, especially as my birthday approaches. I wrote, ‘with the coil comes new hope. Hope that 24 will see me make up for time lost at 22 and 23’. It’s a bit Star Wars but still, I’ll drink to that.
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