Patient: Hello,I need some advice on contraception – I’ve had adverse side effects to 3 types of pills, and the depo injection was working for a while (6 years) but then I stopped to give my body a break. My periods returned normally quite quickly and for the first couple of months I asked for some help with the heavy bleeding. They soon settled down though and everything was fine. I tried the Depo again about a year later but this time I suffered from 2 week long periods every 4 – 6 weeks along with a notable drop in my sex drive and some depression. I stopped taking it and asked for something else instead but my GP has refused to give me anything anymore. They’re saying I’m out of options now and that’s it. They won’t consider an IUD because of the heavy bleeding previouly even though my periods are fine now, and nothing else hormone related will be considered. This is really messing things up for me as I can’t start a relationship with anyone, can you offer advice on how to make them reconsider? I’d really like to try a copper IUD bu can’t make them see how big of a problem this is for me
Symptoms: Sypmtoms from the pill were severe migraines, palpitations, black outs, dizzyness and nausea. Symptoms from Depo the second time around were extended and more frequent periods, depression and total loss of sex drive.
Doctor: Obviously you are in a very difficult situation. Hormonal contraceptives are probably ill suited to your body and I unde rstand your doctor’s reluctance in prescribing them. Abnormal uterine bleeding is definitely a contraindication to intra-uterine devices (IUDs). It is also a health hazard for you to have frequent and heavy periods. Copper based IUDs have been known to have side effects of heavy bleeding and given your past history using it may aggravate your condition. I recommend that you request your GP for a reference to a gynecologist. He/ she will be able to assess your situation more objectively and if any particular reason is found for the abnormal bleeding, he/she will be able to treat it. After treatment, if it is deemed appropriate you will become eligible for an intra-uterine device. There are also newer progestin-containing intrauterine systems that could be suggested to you. As you have tolerated progesterone based contraceptives in the past, it might just work for you to use a progestin- containing IUD.Until you are thoroghly evaluated and treated however, the best contraceptive options available to use are barrier methods and emergency contraception. There are various forms of barriers available in the market and you could choose what suits you best. Knowledge of how to use an emergency contraceptive will enable you to safeguard yourself from failure of the barrier methods.Do not be disheartened by the inability to use the hormonal methods. Educate yourself about the other options and you shall not have to suffer any longer.