QuestionQUESTION: Hello! thank you for taking time to read my question. A bit about me: I am a 19 year old female with type 1 diabetes. I am fairly active and have a BMI of 27.
I have tried various methods of hormonal birth control since 2007. I started with the pill (Marvelon) but quit because I wanted an even lower dose of hormone and didn't want to worry about taking pills on time. My Dr then recommended NuvaRing, which I thought was the answer to my prayers, until I started having sharp pains in my left calf and on the left side of my upper chest. I did some research and learned that NuvaRing is notorious for strokes and pulmonary embolisms, compared to other brands. I then looked into the possibility of the Mirena IUD (I have been in a monogamous relationship for 3 years and don't plan on changing any time soon!), but he discovered that I have frequent gardnerella infections, so he didn't want to take the risk. I'm back at square one now. What can I do besides use a condom? is NuvaRing really that deadly? What is my best option? I'd rather not bug my gyno, as I harass him enough already :P I'm at a loss.
ANSWER: As far as I can tell, it's not certain at this time whether NuvaRing causes more blood clotting problems than any other combination birth control pill. It has a third generation progesterone, and there are conflicting reports. The FDA has not taken it off the market, and I'm sure they've studied it. That said, since you did have calf and chest pain while on it, I would avoid NuvaRing or other combination birth control pills. I would think the Mirena IUD would work well for you. I don't know of any relationship between the Mirena and gardnerella infections or BV. I wouldn't expect any relationship, since the Mirena is inside the uterus, and gardnerella infections are only in the vagina. I suspect that if you get a second opinion from another gynecologist, you could get the Mirena. Another possibility is the progestin only pill, or minipill. It's not quite as effective as the combination pill (2 pregnancies per 100 women per year) and does require taking a pill every day. There is a progesterone implant (Implanon) which is like a match stick inserted under the skin which is very effective and lasts for 3 years. It has the same progesterone as the NuvaRing, but no estrogen, and I haven't heard anything about it causing blood clots. It does cause some irregular bleeding. The progesterone only methods are good as far as diabetes and blood clot problems. I hope this has been helpful.
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QUESTION: Thank you for answering my question. It gave me some hope. I really do like the idea of the IUD, as the hormone absorption is very local, unlike the other methods you mentioned, which probably go into the bloodstream and require a pill every day. I'd really like to keep my hormone levels as close to natural as possible.
I have also been reading about the possibility of a copper IUD. You should probably know that I've never had any children and usually get very irregular, heavy and painful periods. I know the copper IUD causes more discomfort than Mirena, but why? and for how long? (I don't mean to pester you, I'm a student nurse, so I like to know why's :P) will it be uncomfortable for the entire time it's in?
I'm still leaning towards Mirena, but I'd like to know all my options.
AnswerHello Meg,
All the IUD's until the Mirena have caused heavier and sometimes more painful periods, especially in women who haven't had children. I think this is because an IUD is a foreign body, which the uterus knows doesn't really belong there, and may try to expel. I think the Mirena counters this by its progesterone, which makes the uterine lining thinner, so there is less period and less reaction to the IUD. Since you haven't had children and already have heavy and painful periods, I suspect you'd be very unhappy with a copper IUD. Very likely you'd have heavier and more painful periods, and that may last as long as the copper IUD was in place.
Good luck in your nursing career.
