Tag: Female Sexuality

The pill & my face #Periodically 31

Here’s a blog I didn’t want to write but that’s been itching to get out for a couple of months. It’s about a problem I didn’t realise the extent of until the worst had passed, so keep in mind that this story has a slightly happier ending than most of my blogs!

A Skin Thing

I have never had particularly ‘good’ skin — that is to say since puberty I have always had some acne. But it was completely synced to my menstrual cycle and, while annoying, it was totally manageable. The only time it got a little out of hand was around exam periods, which was always perfect considering exams are nearly always rounded off with a prom or a summer ball. But that was as bad as it got. When I was on the pill in the past I noticed changes but never anything drastic, other than that it was much better when I finally came off all hormonal birth control in 2015, by which point I was 20 and thought maybe I was just beginning to grow out of it.

When I went back on the combined pill in February of this year I was prepared for a little skin turbulence. I knew that while things were settling it was likely to get worse, but I also knew that the general rule preached by my doctors and countless anecdotal stories was that my acne was likely to improve on the pill. At the time, it felt like the only silver lining of selling my pill-free self to the hormone gods.

What I didn’t expect was that when things did eventually settle on the pill that my face would be taken hostage by what my doctors were by now calling “adult acne.” Oh good, not only am I spotty but I’m also out of the designated spotty age bracket!

The irony is that I took the “before” shot thinking “my skin is going to get so much better!” A classic case of you don’t know what you’ve got ’til it’s gone…

My GP immediately said, “that’s unusual, it usually gets better,” and my gynae said, “that shouldn’t happen.” We literally watched my face get worse and worse the longer I took the pill — it was like an accumulative allergic reaction. This was the only visual sign I had of my “improving” health, which didn’t make things feel all that improved — shocker! “If it’s not supposed to do this then surely it’s a sign that there is some kind of hormonal imbalance in my body?” I asked my doctors. They both agreed but said there was no point investigating it because “we know so little about hormones that even if an endocrinologist did spot an anomaly we wouldn’t know what to do with that data.” Which, while completely true, didn’t make me feel much better.

Remember how a few months ago I said, “it’s a bummer but acne is something I am well-used to dealing with, and I’ll take it over pain any day“? I don’t necessarily take that back, but when your pain hardly improves and your acne just descends into total chaos it’s hard to take it on the chin (very literally). To add insult to injury, the blistering hot summer we just had meant that 30 million freckles also descended on my face (regardless of how much SPF I put on). I just felt and looked like a bit of a mess. No wonder I started taking Bookstagram so seriously, I was hardly likely to be posting summer selfies. In fact, I now realise that I was cutting my face out of Bookstagrams to hide the acne, case and point:

(Remember kids, Instagram is a web of lies!)

Funnily enough, this did not help my mood, which was already being tormented by raging mood swings and rampant PMS. I’m pretty good at hiding acne with makeup but it was so painful that I didn’t want to touch it. I like to think of myself as pretty skin-positive (I love everything Em Ford does for the movement!) but I really avoided leaving the house or wearing makeup unless I absolutely had to. Dyspareunia and vaginismus aren’t exactly conditions that make one feel particularly sexy, throw some angry acne into the mix and it understandable results in a slight crisis of confidence.

However, I’m not beating myself up about that too much. I did eventually think, “stuff it, I don’t have to look at my face when I’m out, that’s the rest of the world’s problem.” But it’s not great when you do finally leave the house, spots-and-all, and are then bombarded with well-meaning people telling you to “drink more water” or “try this horrifically expensive product.” And when you dare say that you chug water by the gallon or that you can’t afford this particular product then somehow it becomes your own fault — you’re not trying hard enough and therefore you want your skin to be bad… Um, sod off?

There’s no doubt in my mind that there are dietary changes and some products that genuinely help some kinds of acne. Hell, I’ve tried lots of them, but given how quickly and aggressively this came on it felt so obvious to me, and my doctors, that it was hormonal. Personally, changes to my diet have never made a difference to my skin, but I think acne is nearly always a case-by-case, individual issue and unsolicited advice about it, for me at least, is always unwanted.

A little bit of this and a little bit of that…

As promised this story has a happy-ish ending. My GP and gynae both suggested that the pill was more likely to reduce my pain if I skipped periods. This meant I would take two or three pill packets back-to-back without a withdrawal bleed. When I eventually gave it a try my mood improved in a matter of days and everything else followed. I had no idea it would make such a big difference but it really did. Around this time I also started using prescribed Adapalene gel and taking Evening Primrose Oil. Whether it’s one of these treatments or a combination of all three, the last two+ months have seen a drastic improvement in my acne, mood and (fanfare please) pain! (Typically, three days after I penned this blog things got a little worse again, but overall things are definitely better!)

What now?

It’s getting better as the scarring goes down and the further away I am from my last withdrawal bleed the better my skin is, but considering going on the pill was a last-resort solution for my pain, this skin journey doesn’t exactly feel like a triumph. The last few months have mostly been about treating problems that the pill caused. As mentioned, I have finally noticed an improvement in my pelvic pain but I would be lying if I said I don’t worry about what happens to that progress if and when I have sex or come off the pill. Long-term readers won’t be surprised to hear that staying on the pill for the rest of my ‘reproductive life’ isn’t my plan of choice.

Why didn’t I want to write this blog? Because I didn’t want to start moaning about something else. So many of my friends have struggled with their skin for years, dealing with Roaccutane and its complications. Eight months of bad skin hardly feels worth complaining about in that respect. But I had no idea that the pill could have this effect — so that’s something I’m keen to share and leaving it out of these blogs felt a little dishonest.

Love the skin you’re in, unless it bloody well hurts, in which case: seek medical intervention… Thanks for reading!

September 17, 2018
Down a different rabbit hole… #Periodically 30

For whatever reason, the area between my legs has always been a place of curiosity for me, perhaps not helped by my discovery of the vagina-brain connection theory discussed in Naomi Wolf’s Vagina. Recently, and with help from my psychosexual counsellor, I’ve realised that this ‘curiosity’ might have meant I always had a certain ‘vulnerability’ to something like vaginismus. Perhaps it was always lying in wait and it would just take an unfortunate combination of events to trigger it.

But it’s not just the vagina that I’ve been curious about — for most of my life, the uninary system has caused the most trouble. The exploration into gynaecological causes of my pelvic pain over the last couple of years has overtaken a bit, especially since when I raised the subject of urology with my doctor last autumn, he said, “you don’t experience painful periods or painful sex unless there is a gynaecological problem.” It was only last winter, when I was clearing the loft with my mum and considering starting counselling, that I found some note cards from 2007 that made me wonder if my bladder might be playing a role in my present situation.

Hilary’s obsession with bodily fluids circa 2007

As part of a public speaking exercise, I chose to talk about cystitis and toilet access in schools. What inspires an eleven-year-old to give a speech about urinary tract infections (UTIs)? A long and complicated history with them and bladder weakness, even at eleven. I had a few kidney scans as a kid but the general consensus from my doctors back then was, “she’ll grow out of it.” Lo and behold I did not. The UTIs subsided during puberty, but once I started having sex they returned. I had a reputation as an obsessive pee-er as a kid, I planned my day around when and where I was going to wee, a habit I still sometimes catch myself practising now.

Throughout this whole process investigating my bladder for something like interstitial cystitis seemed like such an obvious path to take and it’s finally happening. Last month I saw a urologist and, as always, I was armed with a list of things I thought relevant to mention, and for the first time ever, all the points on my list came up as a result of the doctor’s questions. I didn’t have to suggest anything myself. Dr K was immediately nodding and it was like my body was doing all the right (or wrong) things to have been sent to this department.

Dr K has referred me for (yet another) ultrasound, took a urine sample and then started mentioning some elusive “other procedure” and because I’m a moron I didn’t actually ask what this third procedure was. And then a letter came in the post while I was on holiday informing me that fairly soon I’ll be having a camera up my urethra (flexible cystoscopy). OH GOOD.

As always, I’m excited to explore another orifice (lol) but I’m worried about traumatising my body with another pelvic procedure, especially since I’ll be conscious for this one. I was given almost no information about what to expect or how to prepare other than to “bring some small change and a urine sample” — are the two connected? I rang the department to try and find out a little more and was told “it’s just like a smear test,” which is really helpful because a) I’ve never had one as I’m under 25, and b) pelvic examinations have been so painful in the past that I was diagnosed with vaginismus. So I wouldn’t say I’m feeling totally relaxed about the whole thing, but when I look back on the last two years with fresh urological eyes, there are a lot of unanswered questions. Like the fact my pain started around two memorable events, only my doctors chose to focus on one; a) a period so painful I left work to go home and vomit/cry and b) having a drink spiked and feeling like I was hungover for three months because of what turned out to be a bladder infection.

My GP isn’t convinced that the answer to all my problems lies in my bladder, and neither am I. Going back on the pill certainly hasn’t ‘fixed’ me but my body’s reactions to it and the adjustments in how I take it have confirmed that there is undoubtedly something hormonally abnormal going on in my body. And yet I can’t shake the sneaking suspicion that a piece of the larger puzzle might be in my bladder.

August 30, 2018
I changed my mind #Periodically 29

Maybe it’s because the idea of pain management came up directly after a flare-up, or maybe it’s because the drugs were actually working, but about six weeks into my trial with the low-dose anti-depressant amitriptyline, in an attempt to reduce my pain, I began to feel like this pain management route wasn’t for me. I sat on it for a couple of weeks and it wasn’t a decision I took lightly — I was well aware that maybe I was feeling like I didn’t need the drugs because the drugs were working. Except that wasn’t true at all, I was still in pain.

The only noticeable difference was that my bizarre dreams, which I’ve always had a lot of, all became nightmares. I’ve heard that anti-depressants can mess with your dreams or stop them completely, the latter is a pretty scary idea for me. As a writer, I need my imagination to be relatively unhinged and out of control. The nightmares I can handle, but the idea that upping the dosage might mean I stop dreaming at all did not sit well with me.

I knew if I went to my GP and said, “no I haven’t noticed any difference in my pain,” then her response would be to up the dose, as is standard procedure. But the very notion of how anti-depressants work as a means of pain management has bothered me ever since my GP first mentioned the idea. She said she was prescribing them, “essentially, to stop you feeling pain.”

As nice of an idea that is, I don’t consider it to be a practical long-term solution, especially when I feel like there are still stones that have been left unturned (i.e. urology). Plus I don’t want to stop feeling anything, I just want to be in less pain, if that makes sense?

I’ve now started with a psychosexual counsellor who is trying to make it dawn on me that my chronic pain may well be just that — chronic. I’m not too hot on accepting this “truth” just yet, but because of it, pain management is definitely something I shouldn’t shy away from. I need it for the sake of my mood, my work and my relationships (of all natures), but I think I’d rather open my world up to alternative pain management options before I put all my eggs in the amitriptyline basket.

I discussed this with my GP and she agreed that it sounded like prescription pain management wasn’t the right course for me yet after all, and has instead finally granted my wish and referred me to a urologist. This means a lot to me — I’ve had issues with UTIs, my bladder and kidneys since I was two and while none of my current doctors are wildly convinced it’s got anything to do with my pain, for me, it feels like a really obvious path to explore. Here’s to owning your own health journey within the NHS!

July 23, 2018