awaiting US results and insight on my lab results and other things

[glass-houses.livejournal.com]

Hi folks. It's been a long time.

I had a Paragard for a year and a half a few years ago, but I was a fool and used a cup and found it sitting in there like a necklace pendant. I felt guilty and embarrassed that I did that to myself, so we went back to using condoms. I don't mind condoms, and he doesn't complain. Do they still make Magnum XLs? I can't find them anywhere and they were the perfect size.

I saw my gyno a couple weeks ago with concerns I've been having for at least a year. My libido has been all but absent; my periods, though they start on the regular, are still long and painful and very heavy. My periods have always been long and heavy, but not particularly painful until I got the IUD, and when it expelled I thought and hoped the cramping would at least decrease, which ended up not being the case.

I had a transvaginal ultrasound to check the lining of my uterus, my ovaries, etc, and I have an appointment with him on Monday to go over my US and lab results. I work in the hospital lab so I've already looked at the results. I've been anemic for a while but I compared the CBC results with past ones and I am very concerned. I'm not sure how to interpret the results, but the reference range for hemoglobin is 12.0 - 16.0 G/DL. Mine is 9.8, which is the lowest I've ever had; under 9.0 is considered a critical result. The reference range for hematocrit is 36.0 - 48.0 % (?) and mine is 30.1. My red blood cell count is low and my RDW (I don't know what that stands for) is high. So, I'm a ton more anemic than I was. I know there are different kinds of anemia so I'm curious. I also had my LH, FSH, TSH and free T4, none of which I have previous results to compare, but the TSH and free T4 are in normal range. As for the LH and FSH, I don't know how to interpret them, as there is no good or bad reference range.

I've had little to no libido for a while now, possibly close to a year. I feel bad for my boyfriend, but he's never complained. I've cried so much over it. He has consoled me many times, and I've apologized over and over. I give him occasional blowjobs even when I don't want to, just to make him happy and prove that I'm not disinterested in him. I've also told him that I would love for him to initiate sometimes as I'm the only one who does and with that I feel tremendous pressure. I don't even masturbate. I have to force myself to.

I have bipolar II and panic disorder (and other things) so I'm extremely wary of HBC. My gyno asked if I would be interested in getting the Mirena or using the Ring, which I've used in the past, since their hormones are localized and less likely to mess with my psych issues. I'm afraid the IUD will cause me pain, because it did make me cramp more and it hurt when he thrust too deeply inside me (he is, ahem, kind of large, at least for me), but the idea of having lighter, or even non-existent, periods is extremely attractive. He would have me skip the week where I'd get my period (I don't know how to explain this correctly). I have an appointment with him tomorrow so we'll see.

Sorry for the tl;dr but thanks for reading if you did!

Comments

[atalanta0jess.livejournal.com]

I don't have a ton of insights, but I wanted to tell you that the hormones from the nuva ring are NOT localized. It's a systemic medication just like the pill is, it just has a different delivery method. Therefore, it has the potential for all the same side effects as other combined hormonal methods, including impacts on your moods.

[theatreant.livejournal.com]

Seconding this. I got put on the ring because my NP told me it was localized and wouldn't make my mood go wonky like the other pills I had tried, and it definitely did so I had to stop using it.

[glass-houses.livejournal.com]

Hum, well I've used the ring in the past and I don't remember any particularly bad side effects so I guess I'll still keep it in mind. Thank you for the info.

[knittinggoddess.livejournal.com]

Are you on lamictal for the bpd? That one doesn't do too well with combined hormonal birth control, but Mirena is ok. Here's an IUD_Divas post on the topic. (http://iud-divas.livejournal.com/3119220.html)

Of course, if you're not on Lamictal, and NuvaRing has worked well for you in the past, then carry on! It is a lower dose of systematic hormones than the pills or patch, so maybe that's the key.

[glass-houses.livejournal.com]

I am, actually. I wasn't on lamictal when I had the ring. I'm seriously considering the Mirena but the pain scares me.

[knittinggoddess.livejournal.com]

The pain of insertion, or the pain of sex? Because you've been through the Paragard insertion, and from what I've read on IUD_divas, the two don't really differ that much. There are ways to make insertion more bearable though: timing of the insertion to be during your period or ovulation, using a cervical softener/opener, or cervical numbing, getting a really skilled inserter, etc.

As for the sex, it's somewhat common to have a more sensitive cervix after insertion. Usually it goes away after a while, but it does become habit to be aware of your cervical sensitivity and when you can deal with deep or rough penetration, and when you can't. Here's an IUD_Divas poll on the topic, including people's solutions. (http://iud-divas.livejournal.com/2982559.html)

It's also possible that your uterus was just barely big enough for the IUD, leading to pain and yes, expulsion. I've heard too many stories about people getting different measurements of their uterus each time they were sounded to be convinced that the sounding procedure is very reliable!

If it's the case that your uterus isn't big enough for a Paragard or Mirena, and you have the means to acquire an IUD from Canada, they have a larger variety of sizes.
(I'm assuming you're American, though now I don't know why.) There's even a clinic in Vancouver that provides a frameless IUD that has a lower rate of expulsion and also supposedly is less correlated with increased bleeding or cramps. Look for the Gynefix tag in IUD_divas.

Could your BPD and panic meds be contributing to the lack of libido? SSRIs are really really good at killing libido; I don't know about Lamictal.

[glass-houses.livejournal.com]

Both sources of pain. When I had it inserted, I felt a pinch and a slight cramping, but for some unknown reason I got lightheaded and almost fainted. They made me lie down for a while and when I tried to get up, apparently I was still looking bad so they made me lie down again and my dad had to pick me up. I was working evenings then and I had to call out of work. A bizarre reaction to an insertion, I'm sure.

I must have a sensitive cervix because I'm almost always aware of it :/

I've gotten suggestions that the meds could be affecting it but I've been taking the exact same doses of the same cocktail for more than 2 years and never had a problem before. I'm not on an SSRI for that reason.

[knittinggoddess.livejournal.com]

You probably had a vasovagal reaction (http://www.mayoclinic.com/health/vasovagal-syncope/DS00806) during your insertion. I get them all the time for ridiculous things--blood draws, shots, TB tests, ear exams--and definitely had one for my Mirena insertion! But I came prepared with a semi-full stomach, and the nurse had me lie down for as long as I needed afterwards. In fact, she didn't let me get up until I had waited at least ten minutes.

Hm. If you were always aware of your cervix, maybe it was too big for your uterus. There are a few stories from IUD_Divas members about how they had recurring pain with their Paragard or Mirena, and then switched to a smaller IUD with great success. Alternately, others who had the super sensitive cervix issue later realized their IUD was either expelling or doing this thing where it would start to expel and then move back up.

[glass-houses.livejournal.com]

Is there a size difference between the Paragard and the Mirena?

[knittinggoddess.livejournal.com]

There is, but it's pretty minimal: Paragard is 36 mm long (http://www.drugs.com/drp/paragard-t-380a-intrauterine-copper-contraceptive.html) and Mirena is 32 mm (http://images.rxlist.com/images/rxlist/mirena2.gif). They're both the same width across the arms, and I think Mirena is a tad narrower when it's being inserted--though don't quote me on that last one.

[glass-houses.livejournal.com]

Do you think it's enough of a difference to work for me? Sorry, I know you're not a doctor but you're really knowledgeable and helpful :)

[knittinggoddess.livejournal.com]

I don't know, unfortunately. Maybe, but I bet it depends on your dimensions and exactly how big your uterus really is. If you post the question to IUD_divas, you'll get people who have been in your position and can answer more surely.

[pootski.livejournal.com]

Vasovagal reaction - wow - I didn't know there was a name for what happened to me a couple of times. (Embarrassingly - fainted at the sight of obviously fake blood on a first aid training video, and fainted at the sight of a tiny drop of my own blood after a pin-prick). Thank you! This is a thing. Yes!

[lurkch.livejournal.com]

Regarding your question about condoms: Yes, they do still make them but you may have to buy them online as most drugstores (at least where I am) don't stock them. There are also other brands that serve the same, er, demographic.

[glass-houses.livejournal.com]

Ah, boo. Looks like by the time we get through this box I will have changed the method already (hopefully).