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Contraception advice please claire Q!

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A huge thank you to everyone who posted support last week. I felt alot better knowing that other people believed me.

Thankfully simon believed me too and the whole thing has made us a lot stronger.

Could I please ask for some advice from claire. Simon and i are having incredibly bad luck. The second condom in a month broke this morning and I am going to go yet again to have the morning after pill when the shops re-open tomorrow. I have been reading about getting an IUCD fitted and i was wondering about the logistics of it. I read that a doctor would need to fit it which is fine but do I ring my GP 3 hours drive away and ask for an appintment to talk about it, or can I get it sorted more quickly by contacting the sexual health clinic here and asking them if they can fit me in some time. I have no idea what questions i should be asking to be honest. i know the general things that the NHS can tell me about what the IUCD is and what the side effects are, that I will need a local anaethetic etc. I just need to get it sorted soon and i don't want to go on the pill agai. I was crap at remembering to take them.

Oh my goodness though, guess what? I crashed my car into a post on friday night.

I'm really not having good luck at the moment.

At least i'm in love.

Liz
xxx
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On April 8th, 2007 10:14 pm (UTC), scatmania commented:
I'm sure Claire will post something soon. In the meantime, a quick conversation with her yeilded the following suggestions from the pair of us (we've been drinking, and we expect you'll appreciate a sober answer from her tomorrow):

* Before diving into the IUCD as a solution, be aware of some of the alternatives: Claire and I successfully used the injectable contraceptive for about a year, maybe more, without problem. You get an injection once every three months, so it's hard to forget (and you can be up to a week late and still be covered), and it works in the same way as the pill, so if you've taken that without side-effect before, it'll "work" for you. Plus, after the second or so injection, your periods will stop as your hormones become "levelled out". Downsides: well, it's an injection in the arse. It can be performed by any sexual health nurse, so you could probably get it done, like, tomorrow if you so wished.

* Also consider the implant. Works the same way, again, but lasts 3-5 years. You *can* feel it in your arm, if you know where to fondle, but it's otherwise very discreet. It's added under local anasthetic, and is apparently only uncomfortable for a couple of days (and again when it's removed or replaced).

* Okay, now we'll get onto the coil. I'll share with you some of my experience of it, but bear in mind that Claire will undoubtedly have a lot more to say. Claire initially reported some discomfort and pain when having it inserted, owing to her small cervix (before 1990 or so, the IUD would typically only be offered to women who had given birth before, to reduce the risk of repeatedly jabbing the cervix with what is essentially a plastic tube from a biro). We decided on the IUCD based on several factors, including the fact that it lasts longer than the implant and that there is no local practitioner qualified to do the implant - factors that may not be relevant to you or have different importance weightings. In addition, there have been half a dozen times when I've felt the (quite sharp, be warned) "tails" of the coil during sex, and on one ocassion even managed to leave a mark. It's always possible to maneuver the tails into a different position (either with a well-placed finger or simply by shifting sexual positions). Okay, disadvantages aside: the IUCD works from the second it goes in, can be used as a substitute to emergency contraception (so if you can find a doctor tomorrow, you're laughing), and you're theoretically fertile again from the second it comes out. Apparently there's a risk that it can come out of it's own accord (happened to an aunt of mine once), but again, for a non-mother, it's very unlikely.

Did I mention you have to have check-ups on the coil for weight gain? Perhaps you do for the implant, too, but - if you can stomach it - the implant seems to me to be a preferable option. Just my thoughts.

Oh; and if you're considering switching from a barrier to a hormonal method of contraception, and you haven't already, it's a great excuse to get tested for all the other things a barrier keeps you safe from. Make a day trip of it and see the STD nurse: you know you want to!

Good luck with it. Claire and I are, I'm sure, available for whatever questions you can throw at us - between us, we've tried pretty much every contraceptive method under the sun.
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On April 9th, 2007 09:48 am (UTC), eskoala replied:
IUD
Dan's said a lot of it, but a couple more things to mention:

There are 2 types of coil, the IUD and the IUS. The latter is bigger, but is surrounded by progesterone, rather than being just copper. I have the IUS. Regarding the "discomfort and pain" when it is inserted -- OW OW OW. It was really quite painful, but only took a few minutes, though for a good half hour afterwards I couldn't walk properly -- something about the "vegas" nerve apparently. I'm not a great fan of specula, and they do insist on checking it once a year. Oh, and when they put it in, you think they're done, but no, they were just checking that it would fit with a "dummy" stick first, *now* we're putting the real thing in...

I came off the injection because the people at the FPC said they had to warn people off it because of the high doses of progesterone being dangerous. Both the implant and IUS use progesterone, but lesser amounts (especially the IUS as it is in the right place already). I thought that the implant would turn out to be dangerous too, but apparently it hasn't.

So yeah, if you can stomach it, go for the implant. If you don't want to see your contraception, go for the coil, but bear in mind your lover may be able to feel it.
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On April 9th, 2007 03:07 pm (UTC), norasdollhouse replied:
Re: IUD
'My lover' eh! sounds sexy!

I was thinking about the IUCD (is the IUS the same?) Anyway, I was thinking about that because I as i understand it you were having some hormonal problems with the depot (injectable). Is that right?

On the IUS/IUCD side effects, do you get any weight gain with the IUS/IUCD? If you get weight loss, which I'm guessing is a no can I get more than one? That isn't a serious question but feel free to answer it.

Can Dan actually feel it? That is mad!

I saw Rachel's implant a few years ago and I didn't like the thought of a scar to be perfectly egotistical about it.

Pills are pooh!

I dont have a sexual health clinic at home so can i make an appointment with my GP to discuss it? I'm guessing that will be a yes.

Feel free to give me any advice you think is appropriate.

On another note at work we are doing alot of research about injectable anti-depressants and public opinion. Some psychiatrists are arguing that an injection into the posterior is humiliating to those who have to have it, and takes away their feeling of choice. do you agree? I'm asking on your views as someone who chose a injectable form of medication. could I ask what your reasons for that choice were?

Liz
xxx
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On April 9th, 2007 10:18 pm (UTC), reaperkit replied:
Re: IUD
Hey,

Fiona has an implant in. It is due for replacement this summer.
Yes, if you "poke" at it, you can feel it - but I think she basically has forgotten its there as a general rule. They inserted it right up near the top of her arm, so even a t-shirt comes down past its point, and I don't honestly think there is any scar there. To be honest, how much of a scar there will be will depend a) on the competence of the inserter and b) your bodies defences, etc. healing.

Sorry - there is a tiny white mark where it went in. She tells me that there is a risk of a slightly more prominent mark on removal. However its really virtually invisible.

People are generally fascinated with it, and only know where it is on her when she shows them where to poke - you can't see it just looking at the arm.

It lasts 3 years - they removed the 5 year one from the market in the uk - or it was pulled somewhere and the uk never approved it.

Oh yeah - Fiona just told me she has only had three periods in the last 2 and a half years. Apparently this is a good selling point, but that won't happen for all people.

The biggest single advantage over the pill is it isn't affected by your digestive system / what you eat / being ill. Its just there 24/7.
If you want three years of cover, and have been on the pill before, so know what the hormones generally do to you, it has to be well worth considering.

Kit
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On April 9th, 2007 10:54 pm (UTC), eskoala replied:
Re: IUD
Not heard the term IUCD, but I'm guessing it's another name for the IUS.

Hormonal problems with injection: a little, yes, but probably no worse than most women are once a month, except this was once every three months. I don't have an objective frame of reference for this, though!

Weight gain: I have indeed gained weight, but I'm not sure I can blame that on the IUS! I didn't gain any weight at all on the injection, though. It's supposed to be a risk with any progesterone treatment, I think.

Yes, Dan can actually feel it, though only sometimes, it's quite rare now that I've tucked the ends away sideways. They hang straight down to start with, but later stick to one side and then it's better. Too much info??!

Yeah, I was put off by the obviousness of the implant, I think if I had to make the choice again I'd go for that though.

I couldn't remember to take pills either!

Yeah, your GP will dicuss it with you, though very often they have their own biases. Just stick to your guns if you're sure you don't want something.

Advice: Look seriously at the implant, injection, and IUCD, think longterm and shortterm, try to make the best decision for you. :)

I didn't find the injection "humiliating", I think it was a little embarrassing but I assumed there was a medical reason for it going in the bum -- isn't there? I certainly felt that it was always my choice, and whilst I was always a little apprehensive, I always left the clinic sore but happy. Like anal sex.

Reasons for choosing injectable: next step from the pill, same hormone used so side effects chances minimised, no need to go to doctor, not permanent in case of apocalypse (I had recently read The Stand -- Stephen King), implant technology not widespread/available at the time. Condoms Dan doesn't like, so already on non-barrier method.

Hope that helps, continue to ask away!








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On April 11th, 2007 04:35 pm (UTC), littlegreenbeth replied:
Re: IUD
So if you get side effects from the pill will you get the same ones from injections or an implant?? I have tried lots of different pills and it always makes me depressed. I hate condoms with a passion but I can't think of a reasonable alternative. I'm really squeamish about the idea of a coil and I've heard horror stories about them puncturing the uterus and causing infertility. I don't want to risk my fertility however slight the chance and I don't like the sound of the strings. The implant sounds ideal to me but if I were to get the depression I get with the pill then thats no good either. Any thoughts??
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On April 14th, 2007 06:43 am (UTC), norasdollhouse replied:
Re: IUD
There are ther things aavailable. If you don't like condioms or hormonal treatments what about female condoms or femidoms etc?

From what Kit and fiona ar saying it seems that there may be less risk of side effects with implant which s a little bar that is injected into your arm. It is still a hormonal contraception though.

Liz
xxxx
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