Coming down from using hormones is astonishing. Just astonishing.
I've been using the Depo Provera shot since June 09: six weeks after the birth of Little O. You may remember I posted this account of my frustrations at the inadequacy of contraceptive options for women back in April 09, and how shocked I was that there was nothing out there that really fitted my needs. Well, my needs after the early arrival of Little O changed somewhat - I wasn't able to breastfeed him directly and once we had him home the schedule of expressing, sterilising, feeding, and ensuring he stayed upright long enough to not aspirate on his own vomit, just proved too exhausting and I had to give up providing breastmilk altogether. It's not something I'm proud of, but that's what had to happen. Anyway, because I wasn't breastfeeding I was able to choose a contraceptive that interfered with a nursing mother's supply, and so I choose Depo Provera. It is administered by a nurse using a needle in the upper arm and lasts for three months. It's GREAT if you hate taking a pill every day; it's GREAT if you don't want to get pregnant for a while (over 99.9% reliable); it's GREAT if you don't like having periods; and it's GREAT if you hate using barrier methods such as condoms.
Depo Provera SUCKS if you don't want to gain weight (70% of women gain more than 10lb in their first year of use); it SUCKS if you are prone to depression (it has been found to increase this tendency dramatically); it SUCKS if you want to have sex with a partner on a regular basis (it can severely limit your sex drive); it SUCKS if you want strong bones (it can irreversibly affect bone density after two years of continuous use); and it SUCKS if you want to conceive a child in the near future.
Let's go through that a little, shall we?
I am... how shall I put this? A little heavy. I'll admit it. I love food and I love sitting on my arse watching TV, and I hate exercise for the sake of losing weight. I put on nearly 40lb when I was pregnant, although I lost 30lb of that in the first four weeks after giving birth. So I was still 10lb over my pre-pregnancy weight, and I had started that adventure being about 40lb overweight to begin with. So really, my doctor should have advised me that, being about 50lb overweight during my consultation with him, that I should look for another method of birth control until I had successfully lost some weight. I might have smacked him one, and I might have gone ahead with the Depo Provera shot regardless, but I still should have been informed either way.
Secondly, when I went to visit my doctor, my son was still a teeny tiny premature newborn with an extremely rare genetic disorder that no-one, not even a geneticist, could give me an accurate prognosis for. Mothers of babies who stay in the NICU for any length of time are SEVEN TIMES more likely to suffer from some form of post-partum depression than other mothers. If my doctor wasn't aware of any mood changes I was experiencing the first time he administered the shot, he sure as hell should have checked in on me for subsequent shots to make sure this method of contraception was still appropriate. Because after six months, or two shots, it definitely definitely wasn't. I was in full PPD mode, which later led to a more serious mental health issue, and not one single health care professional told me that the Depo Provera shot could be contributing. Also, my doctor doesn't see patients who are there just to receive a shot - you have to ask for a whole other appointment. I really feel that that policy is negligent. At the very least he should have recommended I see him personally after six months or a year, just to check it was still the best choice for me.
Thirdly, while I guffawed at my doctor when he said the shot could decrease my sex drive, I've found out the hard way how true that can be. Having just given birth I wasn't planning on bonking my husband three times a day in the near future anyway, so putting a cap on my sexual activity seemed like no bad thing. However, come six or nine months down the road, my husband and I were lucky if we managed a single bonk in a month. A MONTH! Forgive me for my bluntness, but we used to be four- or five-times-a-week kind of people before I got pregnant. My husband was incredibly patient and we attributed my lack of interest to my adjustment disorder, but it put a huge strain on our marriage when I would only put out on a very limited basis. A marriage needs a healthy sex life, but I was so unhappy that ours just withered away.
The bone thing is disturbing, no? I don't think I've been affected - yet - because I stopped using Depo Provera after 15 months, but the fact your bone density can be damaged so easily without hope of reversal? That's some scary shit.
And finally - if you want to have a child after using Depo Provera, you had better be in it for the long haul. While the company that manufactures it claims fertility can return to normal immediately, there are countless stories on the internet to suggest otherwise. The general consensus among women who know - women who've had at least one child already, used the shot, stopped using the shot, tried to get pregnant again and failed - is that it takes at least as long as you were on the shot to get pregnant again. I used it for 15 months, which means it could take another 15 months to conceive. Wow. They say it can take six months for you to just start ovulating again and to regain regular periods, and another nine to 18 months to get pregnant. Just wow.
I know it's my responsibility to do my own research and work out what's best for MY body before signing up to anything, but I do feel that there isn't enough material given to women about the Depo Provera shot. I certainly wasn't given any literature at my doctor's office, and as a new mother of a special needs baby, I just wanted something that would take away any extra worries I had about getting pregnant for a bit. I was NEVER told about the weight gain, depression, bone density side-effects, or the possibility of it taking so long to conceive again.
I am not an Earth Mother. I am happy to put hormones into my body in order to prevent pregnancy. I hate condoms (I think I must be a little allergic or something, because those things CHAFE) and I was on the pill from the age of 17. I came off it at 25 and conceived within the first month, which meant I haven't had a normal period since I was a teenager. I've always been fine with that because periods are not my friend. I do not believe in embracing something I find unpleasant - just like I find bogeys, eye gunk, earwax, urine, poop, and vomit repulsive. (Actually, baby poop I don't mind at all. I find it incredibly satisfying to clean Little O's bum because then the smell magically disappears. Eye gunk or nose bogeys, however, are a different story. They make me gag.) Anyway, seeing as I'm not mad keen on being a mad woman once a month, I've truly never minded suppressing my fertility with hormones. It's always meant I either had lighter, regular periods, or none at all - and that suited me just fine.
Now, I'm coming down from hormone usage. I have been hormone-free for 14 days and the side effects are quite astonishing. Assuming I'm not already pregnant (more on that in a minute), then I've been feeling my body literally moving itself back into a normal position and preparing itself for a monthly cycle once again. It's fascinating, and not without its aches and pains. I've been having the most dramatic mood swings you've ever seen; I've been sleeping during the day and not at night; I've had stomach aches, back aches and leg cramps; my boobs have been going up and down in size, sensitivity, shape, and texture - and they tingle; and I've felt my appetite decrease to such an extent that the thought of some of my old favourite foods (such as chilli), has made me queasy. I've also, happily, begun to want to shag my husband again. He's been most obliging.
The changes in my body over the last two weeks have been so dramatic that I think I'm going to have to check I'm not up the duff. It's made difficult, however, by not having had that normal monthly cycle for the last ten years. I've got absolutely no idea when I would have ovulated, or even if I'm likely to, or when the date of my last period was. (Erm... October, maybe?) I'm therefore completely baffled as to when I'm supposed to take a pregnancy test. Yes, my husband and I have been having (semi) unprotected sex, but if the effects of Depo Provera take as long to wear off as they say they do... and if I don't know when or if I'm even ovulating... then taking a test too soon could give me a false negative result. It's all tremendously disconcerting.
But I feel better about not taking any hormones anymore. It feels good. It feels right. If my husband and I do conceive soon, then we're thinking about making a more permanent choice for contraception next time. We're discussing vasectomies, tube-tying, IUDs... even donating an entire testicle to science (yes, it can be done. There's a very famous university who does research into testicular diseases, and they offer thousands and thousands of dollars for healthy testicles from men under 35). Whatever happens in the next few months though, I don't think I'm going to go through this hormone withdrawal again. Using hormones was appropriate for me in the past, but I think I've reached a point in my life where I'm tired of bearing the sole responsibility for contraception in my relationship. And I think after the last 15 months we've had, my husband is too.