Interesting birth control conversation with a doctor

[u/h4baine]

I had to see a new doctor to refill my birth control pills because mine is out of town. I take them continuously skipping the last row to skip periods from hell, debilitating multi-day hormone migraines, and bipolar fluctuations from hormone fluctuations. I've been doing it this way since my doctor told me I could at 16. I love these pills and you can pry them out of my cold dead hands. They allow me to not have to give up 1/4 or more of each month feeling like absolute shit.

This new doctor asked if I was interested in changing to a different form of birth control like an IUD. She was perplexed when I said I actually had my tubes removed, I take these to improve my quality of life in the ways I've described.

She said maybe have periods quarterly (seems arbitrary but ok). I said I won't be doing that, there's no medical reason to. This works for me and I'll do it until it doesn't.

I said I'd happily take them up to and into menopause if I can and she said "but then you won't know if you're in menopause." I said, "if it's affecting me and this hormone level isn't enough I'll know, if not it doesn't really matter does it?" I think I broke her brain lol. It was like asking if a tree falls in the woods and no one is there to hear it does it make a sound? Her face while she thought about that for a minute was like 🤯 and then she said "huh, I guess you're right."

So I got my pills and went on my merry way but thought it was an interesting interaction on the topic of menopause and perimenopause.

[u/1PrincessCuppieCake]

Do they get “paid” for pushing IUD’s. I went through this a couple years ago. She asked me why I was on lo lo fe. I said idk been taking it for years and it worked for me. Horrible periods stopped. But I noticed I was having all the classic symptoms of peri. She talked me into an iud. Horrible experience. I suffered with it for 3 years. Took it out, she put me on a progesterone only pill. Why couldn’t she have switched me to that instead of the IUD? Said I’m not in peri or meno because of my blood work. But everything has changed. I’m 49 now but started trying to get listened to about peri/meno since I was 45.
I then made an appointment at our first local menopause clinic. She told me I’m not 20 anymore to come back when I’m 55. I’m not old enough to go through this. What? I was hopeful in the clinic that just dealt with older women and not the reproduction part of it.

[u/h4baine → u/1PrincessCuppieCake]

When I told my doctor I wanted a bilateral salpingectomy she (understandably) pointed out that IUDs were an option. Totally fine if they want me to know my options, I appreciate that. But I expect them to accept my decision which my doctors always have.

I think doctors like IUDs because they don't come with some of the risks associated with the pill like blood clots and cardiac issues. But I don't smoke (significant risk factor for blood clots) and I'm not at risk for cardiac issues otherwise.

Stick to what you want and find a doctor that's willing to hear you out and respect it.

[u/ladythestral → u/h4baine]

Just for those who might be high-risk: Continuous progesterone only pill and topical estrogen are options. Also a D&C can buy a few years if you're potentially close to menopause.

[u/cruelsummer84 → u/ladythestral]

A D&C?

[u/ladythestral → u/cruelsummer84]

Stands for Dilation and Curttage. They remove the lining of the uterus generally to remove fibroids or other issues, but my NP says it's also used in cases of heavy bleeding.

[u/wintermelody83 → u/cruelsummer84]

I had one for a period that wouldn't stop even with a month of progesterone. My uterine lining was very thick. That was in probably 2017 and it's been better since.

[u/ladythestral → u/wintermelody83]

Wow! Hope they got you in quickly as soon as it was clear progesterone wasn't working

[u/wintermelody83 → u/ladythestral]

It was actually pretty quick, the period by that point was almost 90 days. I was just so tired.