It all started last week when I was down to my last pack of birth control pills and made an appointment to stock back up. My physician went through all the usual motions, reviewing all of my forms and confirming a few details about my family health history. She got to the usual question about headaches, the last one before officially giving me the green light on the issuance of my pills: “You don’t suffer from aura migraines, right?”
Long pause. Well, technically…. yeah, I sort of…. do.
I admit that I have always known that being on birth control as an aura migraine sufferer is risky. Women who see the ominous aura, spots, blurry vision, etc. as a precursor to the dreaded migraine headache are at increased risk of stroke and this is by no means a new development. For no good reason other than not wanting to disrupt routine, I have pushed the knowledge of what is thought to be “only” around a seven percent risk to the side, as though I or my loved ones would take any comfort whatsoever in this statistic were I to be the unlucky winner of the stroke lottery. The pill has just worked for me, improving my skin as well as preventing those pesky ovarian cysts in addition to helping me stay baby-free until I’m ready not to be.
Now I’m thirty years old. I know better. If there is a risk and I can quite easily eliminate it, I should. So I took the Responsible Adult path here and answered truthfully after years of downplaying my condition: “Yes, I get aura migraines. So… now what?”
As I expected, the clinician made it very clear that I would not be walking out of there with the pill, at least not “the” pill that most people think of which contains a combination of estrogen and progestin. Estrogen is the precise ingredient that makes the pill dangerous for Team Aura Migraine, so she who doth not want the stroke shall not the regular pill take. I know I should be relieved here, but I confess myself hesitant to now have to research a new contraception method, especially since none of the other estrogen-free options are as effective at preventing ovarian cysts.
Let’s just assume for a second that the cysts are a non-issue. Most of the studies I’ve come across in researching ovarian cysts list poor nutrition, lack of exercise and stress as the main causes of cyst formation, and I’ve taken several steps over the last several years to address each of those factors. If these cysts are under control, now I just have to pick a birth control method that works for me from a convenience, perspective and overall health perspective. The mini-pill, the shot (aka Depo-Provera), the implant and the IUD are thankfully all as effective if not more at preventing pregnancy.
The catch: all of them have the potential for one side effect (among several) that I always thought I’d welcome but am not very excited about: less frequent periods, or even no periods at all. I should be doing backflips. I should be skipping down the street singing hymns and praise. I should be looking up creative things to do with unused tampons on Pinterest so I can make art with these no-longer-needed jumbles of cotton. I’m not though, in fact I’m rather dreading it. It turns out I’m not so eager to let go of Aunt Flo.
The truth is that I’m grateful for my period when it arrives every month! It’s a reassuring albeit unpleasant reminder that my ovaries and uterus appear to be functioning properly. I think of it as the self-cleaning setting on the oven, a necessary monthly purification to get rid of all the reproductive matter that I’ve once again left unused.
Speaking of unused reproductive matter- what if I’m trying to get pregnant? Or more typically, what if I’m trying not to get pregnant? A spotty or missing period is just as inconvenient regardless of my reproductive goals because it leaves me guessing at something that I want absolute confirmation of either way. Each time I miss a period, I’ll be asking myself whether it’s just a side effect or something a little more momentous. Who the heck wants to play period roulette?? Not this girl.
So what am I to do? Ultimately, a lot more research. I’ll need to talk it over with my healthcare professional, read up on all of my options and make an informed decision based on all the facts at hand. I can select one method but not commit to it -if my body is telling me that something is off, I can try something else until I find the right fit for me. See, I may not be chomping at the bit to give up the tried and true pill, but putting my health at risk just to avoid change is definitely not the right choice. So as for the period that I’ve formed an uneasy alliance with, I guess I will perhaps just have to let it go.
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