PCOS, NFP, Implanon, and faith

I promise I won't be too icky with this blog post, but I will be talking about our favorite Aunt Flo. Within the context of faith and healthcare. It's kind of a memoir-ish post. Consider yourselves warned.

I remember worrying that I was the next Virgin Mary whenever my period didn't come for up to three months.  I worried that I could get pregnant from stray sperm on a toilet seat. The details about sex was very fuzzy to me. I know I had the "talk," but I learned the most about sex in high school from reading the cartoony books in the children's sections while shelving them. I also learned even more from taking a Creighton Model NFP class in my sophomore year of college.

No, not because I wanted Catholic-guilt-free sex with people at parties--it was because of my crazy periods.

I've always had problems with my periods since I was 12. At first they came every two weeks. Then it stretched into once every couple months, and the pain would leave me curled up on the couch, whimpering, or on the toilet with agonizing "birth" pains. When I was 13 or 14, my mom's gynecologist kind of listened to my complaints, and straightaway prescribed me birth control pills. I feared I was going to hell, even though I wasn't married and obviously wasn't having sex.

It's not like I was going to get laid at that age, anyway.

It's not like I was going to get laid at that age, anyway.

By the time I took the NFP class in the fall of 2007, I had tried many pills, but they made me feel sick and hungry all the time. Like morning sickness. I was fed up with it, and had read about Dr. Hilgers' approach to actually treating the underlying imbalances, and wanted to see if I could figure out exactly what was wrong with me, and treat that.

I felt like the proverbial third wheel in the class--the only person who was not married. For all they say that single women were welcome, I felt awkward, out of place. At least the room was darkened so we could watch the PowerPoint, because I could feel blushing warmth rising up my cheeks as they talked about penises and cervical mucus and arousal fluids. And at least it was extremely useful sex ed for me.

I dutifully charted with little green, white, yellow, and red stickers, and looked up the code for specific types of mucuses. I felt like I was being a better Catholic.

My cycles went on longer and longer. I'd get cyst pain. And when I did have a period, it was a piddly-assed one where I really didn't need a pad after all. I worried about getting an overgrown uterus, imagining that it was growing larger as each month's lining just built up on each other. And I got married.

Marriage limited treatment options. Perhaps if I had grown up cafeteria Catholic, I would have completely ignored Humane vitae's outdated admonishment against using birth control hormones for reproductive system dysfunctions. That encyclical, promulgated by Pope Paul VI, says that it is immoral to treat gynecologic disorders this way because it will abort embryos. For treatment to be moral, it has to be a cure.

15. On the other hand, the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever. (19)

The only cure for PCOS, which my new gynecologist finally diagnosed, is essentially a hysterectomy and ova-rectomy. Like hell I'm doing that. It's like chopping off a hand because of arthritis because Aleve only treats it instead of cures it.

The moment when BCP becomes a forbidden method of treatment.

The moment when BCP becomes a forbidden method of treatment.

I know that many priests will quietly counsel women that it is okay to use the Pill for treatment reasons, and I have heard many justifications about using hormones as treatments, even if it's not a cure. But when I read Humane vitae, it confirmed what all the conservative and "true" Catholics were saying. Birth control, for any reason, is immoral in marriage. I was angry. Why can't I treat it?

My gynecologist talked about Implanon and Depo-Provera. Because I have migraines with aura, I'm contraindicated for the combo pills containing estrogen. After agonizing for a while, I realized that there is no medical difference between Implanon (which is covered by insurance) and the progesterone shots that Dr Hilgers, a renowed "Catholic" doctor, prescribes (which is NOT covered by insurance.)

My personal struggles was reflected in national news at the time, because of the "contraception mandate." I wished I could whap the archbishops and cardinals on the upside of their heads for the crazy statements about the morality of providing contraception as an option for other women. I also had been wishing I could do likewise for the statements about gay marriage.

I went ahead and got Implanon in 2011. Not much longer after, started on a journey to becoming Episcopalian.

Implanon worked for me. No morning sickness! No more cysts! I finally started bleeding again. Thank God I was able to use Implanon as a form of treatment without feeling condemned by my new denomination. (Episcopalians welcomed my brains as well as my warm body in the pews.)

I bled. And bled. Then it'd dry up for a while. Then it bled again and again. My gynecologist and I chalked it up to my body getting used to the levels of progesterone, as it seemed like I was starting to get more regular after a year on it. Then immediately after that checkup appointment my uterus proclaimed it was only faking me out, and has been bleeding nearly non-stop since Christmas.

Scumbag uterus. Why is it so cheery?

Scumbag uterus. Why is it so cheery?

I'm finally fed up with it (honestly, constant bleeding can't be any more healthier than no bleeding--all I want is to bleed SOMETIMES), and am getting my Implanon removed next week if all goes well. We will be headed back to NFP, not only for charting, but also for avoiding. And to force my uterus to clear out, my gynecologist and I had previously talked about doing periodic (haha, see what I did there?) progesterone challenges.

Re-researching NFP, particularly within the context of post-hormone tracking, I keep running into the conservative Catholic posts about it that are making me kinda cranky. Particularly the ones that decry contraceptives as immoral. And the ones about how if you eat super healthy and take exclusive vitamins it will cure your PCOS and regulate your cycles. It reminds me of all my old religious anxiety about my uterus and ovaries, and part of me wants to avoid that forever and ever, amen.

But it is a legit option. Sure, some call it Catholic Roulette, which it can be if people are bad about tracking. But it's actually pretty effective for people who put forth the effort to track. Certain types of tracking work well for different people, but if you have crazy cycles at all, Creighton Model is probably best. And that's what I'm going back to. No temperature tracking--which doesn't work for me anyway.

Part of my brain thinks, "Well, now that you're not going to be on Implanon, might as well be Catholic again, eh?" but I'm not going to for a myriad of reasons. It's kind of hard to get over the fact that the Church is so suspicious of specific forms of medicine that they will fight and claim "persecution" even though it's also people who have medical conditions it helps to treat.

Anyway. If you have ever struggled with the morality of medical treatments for your own PCOS or other gynecologic disorders, you are NOT alone. We can be cysters together on our journey.

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  • Hi, another woman here with both PCOS and migraines. Have any of your doctors suggested Metformin? It's a diabetes medication, but often used for women with PCOS (especially ones who can't take the Pill, like you and I). Some women have no luck with it, some think it's a miracle. (My experience was in-between.) And I've learned that even though I've finally had all the lady parts removed, I still have to watch for imbalances.

  • In reply to Inconstant Reader:

    Hi, and thanks so much for commenting! I've tried a low dose of Metformin twice, but didn't notice any difference, and ended up quitting it. My gynecologist suggested upping it the last time I quit, because maybe the dose was too low to be effective for me. I'll talk about that with her at my appointment tomorrow. Maybe it will work better when I'm off of the Pill?

    I was reading PubMed, and saw that some doctors are starting to recommend myo-inositol as another way to help women with PCOS, but there is similar mixed results with it. The problem is--that's contraindicated if the person is taking a SSRI, which I am.

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