The IUD Chronicles Part 5: Firsts

How stopping hormonal birth control has affected my period, bacne, mood, libido, and more.

TW: Menstruation, Cervix/Uterus/Vagina mention, Mild Sexual Content, Gender Dysphoria

I’ve been off hormonal birth control for about three weeks now! In that time, I’ve experienced my first period, noticed some substantial mood improvements, gotten a few nasty whiteheads on my back, and finally attempted sex.

The first six months to a year with a copper IUD are the “rough” ones, where hormones are in flux, periods are intense, and side-effects are most noticeable. But so far, I’ve had a very mild adjustment, relative to other people’s experiences I’ve read about. In this entry of the IUD Chronicles, I will be describing the major changes: to my periods, cramps, skin, digestion, sexual response, mood, and gender dysphoria.

Menstruation.

My first period came a week after my IUD insertion. During that first week with my IUD, I bled and bled and bled, and I continued to take my hormonal birth control, as advised by my gynecologist. Both of those factors might explain why my first copper-IUD period was pretty mild.

Well…not mild mild. It was still a heavy period. I changed my tampon every few hours, and always, always double-bagged with a pad to catch overflow. I had cramps that were more intense than I’d experienced during any period in recent memory. I was taking iron pills and cooking eggs and spinach left and right, to recoup the iron I was losing. I felt faint. But, it was nothing like the early days following my IUD insertion itself, and it wasn’t the painful bloodbath I’d been led to expect.

I expect that my next period, due in a week or two, will be the real “first period” post-IUD. For the first time in eleven years, I’m going to ovulate; for the first time in eleven years, my body is going to have to dispose of uterine lining that was actually capable of nourishing a blastocyst. I also won’t have been bleeding for a week already when it hits, like I was with this period. I expect that it’s gonna hurt, and fill my pads and tampons, and ruin some old shitty Target underwear. Whatever happens, I’ll report on it here.

Cramping.

I am still, weeks later, acutely aware that there’s a hunk of metal in my body. And when I do happen to forget, for a few hours or a day, the IUD gives me a familiar twinge to remind me. The cramps are not debilitating, though sometimes I have to Lamaze-class breathe through them or take an ibuprofen. The pain does distract me, though. Stretching out, lying on my back, or taking a hot shower helps.

My cramps are fairly predictable in their etiology: walking long distances, exercising, sitting in a curled-up position (which puts pressure on my uterus/stomach), and masturbating are all common causes. Anything that strains or tenses up my abdomen or uterine area is guaranteed to send shots of pain through my belly and lower back. The pain sometimes is pulsating and dull; other times it’s sharp, and sudden, and localized on the right side of my stomach. It can be really unpleasant. The cramps caused by sexual arousal are especially piercing. More on that below.

Digestive changes.

I am shitting all the time. It is so easy to shit now. I love it.

I believe my uterus is still slightly swollen from the minor physical trauma of getting the IUD inserted. This isn’t as bad as it sounds — the uterus is always slightly engorged during a menstrual period, for example. I’ve always had an easier time shitting during my period because of this. When my uterus is full of blood, or otherwise enlarged, it squeezes on my intestines, making me constantly want to poop. And then I poop. And I feel pure and clean and empty.

I have not been the slightest bit constipated in weeks; my bowel movements come regularly and effortlessly. This is a minor miracle, given that I’ve been swallowing iron supplements like Altoids for weeks. Those fucking pills normally give a person (including this person) hard-ass stools. Right now, between the iron pills and the uterine cramping, my digestive system is in a state of perfect balance.

Skin.

My face looks great! See:

I worried that stopping hormonal BC would cause acne to resurge. But my face has been almost totally soft and clear for weeks now. I have been using a medicated apricot scrub to keep the oil at bay, just in case. That seems to have done the trick. It’s shit fuck rock nipple cold out, so I have been moisturizing my face more diligently than before. That seems to be helping too.

(I use fucking Jergen’s. I don’t know why, but that’s the one moisturizer that consistently keeps me from breaking out. It’s not even made for faces. It has mineral oil in it, which is supposed to be an acne trigger. But when I use it, my skin looks smooth, even radiant.)

I have noticed more substantial skin changes elsewhere on my body. I have drier skin — I’m more itchy and peely on my torso and arms. I have to exfoliate and lotion more. My scalp seems a bit more dandruffy, which I’ve also heard is a common reaction to the copper in an IUD, but I’ve also switched dry shampoos recently, so that could be it too. I have also heard that dry skin caused by a copper IUD can be treated with a zinc supplement. The science on that seems sketchy at best, though.

Also, I have bacne. The bane of my teenage years.

God dammit. I should have seen it coming. As a teen, I used to suffer from big, painful, pus-filled welts on my upper back, which I’d pop and scratch incessantly. They’d scab over, then dry out and turn into hyperpigmented scars, which lingered on my back for years before fading. As an adult, I still can’t resist scratching those fuckers open. They hurt, and they’re so easily destroyed with my tiny chinchilla claw hands.

I learned as a teenager that I could treat bacne by applying witch hazel to the spots, and that I could prevent the worst breakouts by showering immediately after every sweaty activity and forgoing a bra; I’m implementing those very steps right now, and they seem to be helping. The bacne is not as disgusting or painful as it was in my adolescence, and my emotions are now miraculously resilient (see below), so I’m not too disturbed by it.

Sex & Libido.

For a while after getting my IUD, masturbation hurt. Well, to be more specific, orgasming or getting close to orgasm hurt. My vagina, labia, and clit were completely fine from the start — getting an IUD did zero harm to them, and I was still capable of experiencing pleasure. But as soon as my body got really excited, my cervix and uterus tensed up, and a cramp built up inside me. If I kept going, the tension worsened, until pain pulsed through my right side and jabbed at my reproductive organs and intestines, causing me to stop.

It was disturbing. And it sucked, because the lack of birth control hormones meant I had way more desire than I had before.

I was worried to try penetrative sex for weeks. So many bad things were possible. I thought insertion would make me tense up, and send me into waves of aching, dissociative contractions that I wouldn’t be able to stop. I worried that the strings attached to my IUD would jab my partner in the dick — a real thing that sometimes happens if the strings are either too long… or too short.

(Some people have to go back to the gyno to have their IUD strings cut. Sometimes people have to wait for the IUD strings have to soften inside the body, which can take weeks or months, before the IUD-haver is able to penetrative sex.)

I worried sex might feel like getting punched in the cervix, or that it would give me flashbacks of the insertion procedure. I worried that the IUD would get dislodged during sex, and that the metal would puncture the side of my uterine wall. Those are all real things that happen to people sometimes.

I was afraid that orgasming during sex would give me violent cramps. I worried I’d start bleeding profusely the second sex began. I worried that my worries would keep me from having sex for months. I started to think maybe this was how an IUD worked as a form of birth control — by keeping you from ever fucking in a way that could cause pregnancy. I though it might as well have been a cork blocking my vaginal canal.

At the same time, stopping hormonal birth control has given me way…more…of a libido. I’d been wanting to have all kinds of sex, but for weeks I was unable to actually go through with it. Even by myself. I felt a bit stuck. Having more desire was a beautiful thing in and of itself — it contributed to me feeling more alive and vibrant — but I couldn’t fully enjoy it, and I feared I wouldn’t be able to enjoy it for a long time.

As the weeks went on, however, the pain associated with masturbation went down, as did the fear of sex. At the start of week 3 post-insertion, I gave it a try.

And it was fine! I went slow, and I made sure to be on top so I could control the depth and speed of penetration, and it felt totally fine. I didn’t cramp. I didn’t tense up. I didn’t bleed. I was able to orgasm without pain. The IUD strings could not be felt by anyone involved. It had to be a very slow, sensual, cautious encounter, but it worked, and everyone was fine.

After that, sex and masturbation with an IUD have been completely fine. They have been more than fine, really — I can experience pleasure more intensely now you guys. My whole body feels more sensitive and stimulated. I don’t want to get lurid, and maybe I’ll devote a whole separate post to this, but…stopping hormonal BC has made everything feel far more intense and tingly and wonderful. It is not the sex-preventing vagina cork that I feared it was.

Mood.

I am made of beautiful self-satisfied Teflon. I can disengage from bitter, fearful, or irritated thoughts at will. I am productive. I am inquisitive. I love myself, and I am engaged and sociable. I was not like this before.

I used to break down if a kid was screaming in my proximity or a stranger was yammering too loudly on their phone. Now I can observe my feelings of irritation, reflect on them, put headphones on, and get back to work.

I used to weep at night thinking about the inevitable deaths of everyone I love. I still think about depressing topics, as I always have (I’m a morbid fuck, it’s fine), but these thoughts don’t make me cry or keep me awake for hours. I sleep like a stone.

The real miracle of stopping hormonal BC, for me, is my mind has become more fluid. My brain doesn’t latch onto upsetting thoughts or feelings. My thoughts do not circle the same dark, dingy drain obsessively for hours and hours. I still have thoughts of insecurity or sadness, but they float by. It’s like being on good anti-depressants, which I guess, functionally, I am.

I have more energy because I’m not constantly warring with my worst, most wounded, most resentful impulses. I get more work done, and I feel less stress about how much work I ought to be doing. I am able to enjoy doing nice things for myself rather than feel shame over them.

I like myself more. I’m not the brittle, weepy, pissed-off person I so frequently was on hormonal BC. I don’t pace the apartment feeling unlovable if my boyfriend is out late. I can avoid answering a message for a few hours and not feel certain that a friend will abandon me. I can detach if someone is making emotional demands of me that are oversized and unfair. I can tell when my own insecurities are irrational and just… let them go. I can do things I enjoy without feeling pathetic.

I have been leaving the house and going to unfamiliar social events way more often lately. I’m not as worried about being the odd person out. Even if I’m left standing around alone at a show or a party, I feel that I have some innate worth, and that I’m not being creepy or socially fucking up by not being the life of the party.

I’ve been writing a lot. My mind is clearer. I don’t feel superhuman, but I feeel vibrantly alive. Really alive and connected with the world. I don’t resent things that get in my way. I don’t have rigid demands for what my day must look like. I hear my upstairs neighbors fucking loudly and I turn on music and read instead of thumping the ceiling angrily with a broom.

The other day, I missed a bus, then waited seven minutes for another bus,which I unable to board because my Ventra card didn’t have enough money on it. I wasn’t angry at all. I didn’t feel foolish or like a fuck-up for forgetting to check my card balance. I just put money on the card and waited again. The next bus, when I finally caught it, was rumbly and packed full of people, and was driven by someone who took really hard stops. Normally, any one of those things would give me tension headache of frustration. But I just stared out the window and listened to music and let actual, everyday joy pass through me. I felt actual peace on that fucking bus.

It’s been a few weeks since I stopped BC, so I don’t think it’s a placebo effect. I think I truly am a better, more peaceful, more self-controlled person without birth control hormones. That said, hormones fluctuate — I will have bad weeks. And people adjust to changes in their lives; what was revelatory becomes mundane. I won’t always feel this amazing.

I’m cautiously optimistic — the mood improvements alone have justified the pain and inconvenience of getting an IUD, for me. As long as I continue to reap that benefit, in some small amount, I will be satisfied with my choice.

Gender Dysphoria.

I’m not sure if this is because of my mood improvements, the reduction in hormones, or because I’m getting more used to being an out nonbinary person, but I have been feeling way less social dysphoria in recent weeks. I feel comfortable and confident in who I am, and have far less discomfort related to how other people perceive me. I don’t care as much if other people don’t get me. Being accidentally called “she” or “ma’am” doesn’t sting very much. I know that I am who I am, no matter what other people think. I feel less bashful talking about my gender with people. But I’m also not particularly obsessed with the topic.

I feel more comfortable in my body. My body feels less “wrong”. I don’t mind seeming cute or beautiful; I don’t mind the gestures or cadences I give off that are feminine. I know they aren’t a betrayal of my identity. I can enjoy myself more. I’ve found myself loving my shortness, the prettiness of my face, all things that I felt a bit conflicted about before. I’m happier, even, with my chest. All my body’s features are biologically nonbinary features. They don’t make me female. They don’t need to change. I’m delighting in that.

It’s not a coincidence that I’ve been feeling more comfortable in my body at a time when I’m taking control of it. I’ve been drowning in estrogen for a long time. My body has been hyper-feminized by birth control. I don’t think I want to go on testosterone or be hormonally masculinized, but I do want to be closer to an even balance. I also want to feel like my body is my own, not a thing tinkered with by evolution or pharmacology or the expectations of other people.

In Sum:

Getting off birth control is allowing me to reassert control over who I am, and it’s letting me learn what my actual brain, body, and reproductive system are like, unadulterated. Hormone replacement therapy, birth control, and pharmaceuticals can be life-saving, beautiful things, and a lot of people are granted life and freedom by those things. I don’t mean to bag on them. But for now, I’m happy to exist without their influence or aid. I’m very grateful that my natural combination seems to be excellent.

I thought I was depressed. I thought that was innate feature of who I am. But now I’m out from under it, and I’m learning I never had to feel that way. Some of the worst feelings I had weren’t mine at all. I’m so glad to know this side of me again.

— — -

This is part of an ongoing series documenting my transition from hormonal birth control to a copper, hormone-free IUD. You can read part 6 here.

You can read the series from the beginning here: https://medium.com/@dr_eprice/the-iud-chronicles-part-1-why-im-going-off-bc4b2859367e

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