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24 February 2015 @ 12:35 pm
no baby no baby no baby!  
It will come as no surprise to exactly no one who knows me that I don't want to have kids. I've fantasized for years about permanent sterilization, but, of course, I know how much our desires and inclinations can change over time, so I always had age 40 in mind as the point at which I would pursue a permanent solution to the problem of my potential fertility. Since moving into a household with kids, I've been even more sure that that's not a path I want to pursue in life. (I love living with other people's kids. Almost as much as I love not having any of my own.) (Okay, not even close to how much I love not having my own.)

So, even though I'm about 18 months from my 40th birthday, I feel ready to make a longer term decision. So! I met with an OB/gyn this morning to talk about my options. I went in with Essure as my likely preferred option. It's a minimally invasive procedure with good outcomes. The other permanent option is tubal ligation, which is a real surgery.

While I was talking to the doctor, she suggested I consider the Mirena IUD, primarily because the low dose of hormones could alleviate some of my endometriosis symptoms, and most women on the Mirena don't have periods, which is obviously appealing. But it's also appealing to know that pregnancy is totally off the table. So, I'm thinking about it.

I'm interested to hear thoughts and helpful questions, if you have any, but it will make me angry to hear anything along the lines of "But what if you change your mind?" or "Don't you want to keep your options open?", so please skip those!
I'm feeling: thoughtfulthoughtful
veek on February 24th, 2015 05:44 pm (UTC)
Whoa! I admit to being *very* curious about the physical effects of whatever you end up choosing.
veek on February 24th, 2015 06:03 pm (UTC)
Thinking about it more, I actually think I'm more curious about the psychological effects. I'm imagining a freedom and an empowerment. But just as I knew that the reality of parenthood would be different from anything I could imagine before becoming one, I'm pretty sure that this part of your reality will have elements quite unlike anything I can imagine. That's what has me curious. :)
(no subject) - aroraborealis on February 24th, 2015 09:29 pm (UTC) (Expand)
Completely Socially Unacceptabledeirdre on February 24th, 2015 05:55 pm (UTC)
I'm out of date on the research of low dose hormones and long term side effects, did your doc point you to anything recent?

I've gotten mixed reports on Mirena from friends who have them, some love it, some feel like they had side effects they couldn't live with (I wish I could be more specific, but I'm naturally baby free so I tend to tune out the details of birth control conversations).
ruthless compassion: cheersaroraborealis on February 24th, 2015 09:30 pm (UTC)
She gave me some materials, which I haven't reviewed yet.

Naturally baby free! I'm envious!
(no subject) - deirdre on February 26th, 2015 11:52 pm (UTC) (Expand)
blk: pussyblk on February 24th, 2015 06:07 pm (UTC)
I have also been thinking about Essure for many years! My primary hesitation was that it is still a relatively "new" procedure (2002), and that I don't have enough information about the recent controversy regarding potential complications to determine the actual risk. Since other good options are available to me, I want to give it a little more time.

I went on Mirena a little over a year ago primarily because I badly wanted to reduce my menstrual flow. I have spent about 10 years of my like on the pill and had some minor side effects. My experience on the Mirena has been much better wrt side effects, AND I got the much desired effect of a greatly reduced period from VERY heavy to practically ignorable.

The major (but really only) downsides to Mirena for me were insertion (painful, not excessively for me, but I've heard it's worse if you haven't given birth) and I had a very unpleasant doctor experience when I needed to get the strings trimmed. Fortunately both of those things were resolved satisfactorily.

Whichever you end up with, I would be interested in hearing about your experience!

Edited at 2015-02-24 06:08 pm (UTC)
chenoamegchenoameg on February 24th, 2015 06:11 pm (UTC)
Nothing constructive to add, but go you for knowing what you want and doing it.
RiceVermicelliricevermicelli on February 24th, 2015 06:26 pm (UTC)
I love my Mirena, but I wonder why your doc is suggesting it when you came in thinking Essure. I feel like doctors are sometimes chickenshit about permanent sterilization for women who don't have children, and sometimes overeager about it for women who do.

My issues with Mirena are that insertion can be painful, and that there's no guarantee about how the hormones work out. My Mirena is doing wonderfully for me, but given the annoyance of insertion, next time I need a new one, I'm strongly considering Essure. Other people have had different experiences. It's certainly worth considering, but if you decide against it, will having done the Mirena thing make it hard to switch to Essure? Is your insurance company going to be cranky about it or anything?
ruthless compassion: thinkyaroraborealis on February 24th, 2015 09:43 pm (UTC)
Yes, I do think there's some reluctance on her part given that I don't have kids, though I think her level of hesitation was reasonable given that she just met me.

Technically/medically, I could do Mirena and then Essure (or vice versa, if I decided I wanted the permanent solution and also hormones), but good question re: insurance!
(no subject) - signsoflife on February 25th, 2015 02:02 am (UTC) (Expand)
(no subject) - aroraborealis on February 25th, 2015 02:56 am (UTC) (Expand)
harimad on February 24th, 2015 06:42 pm (UTC)
My experience with Mirena was positive. I had no periods, no kids, no noticable weight gain, etc. The insertion and removal process was similar to that of a pelvic exam: not painful but a bit poke-y/weird. FYI, I have had two vaginal births and problem-free periods.

I had it taken out early because I thought it might be connected to my drastic drop in libido but as the removal made no difference (darn it). This supports the literature's claim that it has no libido effects.

One thing to be aware of is the interaction of whatever you choose and menopause.
Mizarchivist: Uva (Butch)mizarchivist on February 24th, 2015 06:48 pm (UTC)
I went with the non-hormonal IUD, as my periods have never been a problem so I was excited not to have to deal with problematic hormones.

Sounds like Mirena's a great step towards permanent sterilization. I'm interested in hearing more about which way you go.
Beahbeah on February 24th, 2015 07:22 pm (UTC)
As a data point, I absolutely adore my Mirena, and have had maybe 3 half-days of light bleeding since I got it 2.5 years ago. No other side effects or anything, just pure adoration.
cheveux sable with earworm rampant: autumn treelcohen on February 24th, 2015 08:36 pm (UTC)
i had an essure done. it took them two tries because the first one we discovered i had a uterus full of polyps (there's a title for a horror story!) but other than that, it's like having cramps for a few days and then a few months where you are still on birth control while the scar tissue forms and then they test it and then you're done and there are no cases of failures. i'm very happy with it. and if you have more specific questions, i'd be happy to talk with you.
sernin on February 24th, 2015 09:00 pm (UTC)
I love my Mirena. I'm approaching the fourth year.

The day after insertion was awful cramps (likely given my not having children) but no problems since. The hormones don't interfere with my other meds.

I would really like to hear about your choice. Being over 40 now, I'll be making another decision when the current one needs to be removed.
goslinggosling on February 24th, 2015 09:29 pm (UTC)
My experience with the Mirena has not been as fabulous as some other women's, but it certainly hasn't been horrid. I never experienced any discomfort from it whatsoever. (I wasn't conscious for the insertion though, as I had a diagnostic D&C at the same time under sedation.) My periods are definitely lighter and less frequent than before. They do tend to last for a really long time, however, (8-10 days generally), which I find rather annoying, and are completely unpredictable.
Madame Blue aka Pygmentsweetmmeblue on February 24th, 2015 11:56 pm (UTC)
Mirena and now tubes removed
I had them take the Mirena out 6 months after putting it in. The insertion (post 2 kids) was no big deal for me. However, I'm really sensitive to hormones and it changed my personality. Also, on an energy level, I could never wind down. I wasn't able to do any meditation for the whole 6 months it was in, I couldn't find my ground point. The day they removed it that stopped being a problem. I was doing the Mirena because I have adenomyosis and they were hoping it would reduce the all the time cramping. It did that.

In December I had my tubes removed. I knew I was done with kids and the doc suggested it instead of a tubal because it would reduce the risks for ovarian cancer. They also did an ultrasound before the procedure and discovered I had cysts on my tubes. Now that they are gone the amount of abdominal pain is much less. I've had 2 cycles since and the cramps are MUCH BETTER.

I hope you find the path that works for you.
Boring Nerdsignsoflife on February 25th, 2015 01:55 am (UTC)
Snip snip!
I had a hideous time trying to get the Mirena IUD installed (fainted on the table both attempts)(getting an IUD through a nulliparous cervix is often hard, but I understand my own was on the far edge of the curve), at which point my doctor pointed me to the NuvaRing, which has similar low-dose hormone stuff going on. My body haaaaated that (the kind of insomnia where you can't stay asleep), so we went back to condoms.

About a year and a half ago I had tubal ligation. I'm really happy with that choice; I particularly like that it doesn't leave anything IN me, and that it's not screwing around with my hormone levels. They just burnt the bridges and that was that.

It's major surgery, but it didn't really take up more of my time than going in twice to try to get the IUD did. I was functional the next day and back to 100% maybe the next week. It's laproscopic these days, and I can no longer find my scars. Plus I have neat pictures of my insides -- I no longer wonder if I have fibroids, for instance, because I have photos of my uterus and ovaries.

My only qualm is that those darn fallopian tubes can grow back together over time. . . but, by the time they're at risk of doing that, I'll be close to "it would take a miracle" age anyway.

I just don't LIKE doctors putting stuff inside me to mess with my entire system and not really knowing what the effects are going to be. I'm super happy with my choice.
unintentionally intimidatingcoraline on February 25th, 2015 05:39 am (UTC)
My mirena made me clinically depressed in ways it took a year or so to recover from. This was after a decade of apparently well-tolerated bcp followed by 5 years of the copper iud. You know someone else close to both of us who had to have hers removed for mental health reasons as well.
So if you go that route, be very aware and if anything seems like it's going subtly sideways, listen.
Scheherazade is my patron saint.: abtinencea_kosmos on February 25th, 2015 06:02 am (UTC)
I considered doing the Essure procedure but couldn't quite work up to it when it was time to have my IUD removed. I couldn't quite work up to it for one reason or another when I had to make the decision last year. Some of it was that the surgical nature and the follow-up testing was sort of daunting for me; had we not gone another direction, I had arranged to get another IUD. I know people who have had the Essure and have thought it was the best thing ever.

Because I'd had problems with hormones in the past, I went with the Paragard - nonhormonal IUD - which was a fantastic option for me from age 28-38. I also have pretty manageable periods, so I wasn't worried about increased cramping. I was incredibly pleased with my IUD experience. It was worry-free and reliable and worked great for the duration. I will say that having it inserted was painful, but that only lasted for a day.

Because the bulk of the birth control had been on me for the majority of our relationship, we decided that it was the Bear's turn this time, and he got a vasectomy last summer (and had one of the lowest maintenance vasectomies in history: no scalpel method, no stitches, and just a little tenderness for a few days). I understand that this might not be in the realm of things that are on the table for you.