Sunday, October 2, 2011

Not So Simple

I've struggled with birth control ever since I started having intercourse with men.  For a long time I was adverse to the idea of hormonal birth control because I like that I can feel my cycle moving through different stages.  It makes me feel connected to my body.

I recently revisited the topic with my doctor, and I also had a long talk with my psychiatrist about it as well.  I have bipolar disorder and anxiety and part of my treatment is taking medication.  Over the years I have been on more medications than I can count and for a long time I refused to take any at all.  Eventually, I was able to find a combination that worked and that didn't have horrible side effect.  It took about 8 years.

I do a lot of other things to manage the bipolar disorder and anxiety, but the medication is crucial.  I would not be able to be as functional or happy as I am today without it.  When I talked with my psychiatrist about how the Pill would interact with my medication, I was reminded that even though I am so happy and stable with my life, I still have these problems.  They don't go away.  There are some things that I will just have to do different than other people.

The problem is one particular medication, Lamictal.  I love Lamictal because it works as an anti-depressant without being an SSRI (like Prozac).  SSRIs make me psychotic- a common reaction for people with bipolar disorder.  The problem is that the Pill make Lamictal 50% less effective and doubling the dose isn't as option.  See, the lone side effect for Lamictal is a very, very rare condition that can occur when there are sharp increases or decreases in the dose.  During the week where I would be taking the sugar pill, my dose for the Lamictal would effectively double, putting me at risk.

The condition is a rash where your skin can fall off.  It can be fatal if not treated.  If I ever got the rash I would never be able to take Lamictal again.  My psychiatrist told me straight out that I should not go on hormonal birth control at all.

Sometimes I hear people talking about birth control like it's the easiest thing in the world.  Like, you just pop some pills and you're good.  I know that is not really true across the board, but I can't help but this about all of the conversations with my doctor and psychiatrist over the past couple months.  Or one of my friends whole also can't take the Pill for medical reasons and is also allergic to latex.  Or another friend who couldn't keep taking the Pill because it made her really depressed.

It's not a simple thing for anyone, and when you toss mental illness into the mix it becomes really frustrating.  The only option I have is an IUD (more on condoms later- that is a whole other post).  Even though the decision had been made, I still haven't worked up the nerve to actually get it.  Soon.


  1. I feel you. I miss being able to be on hormonal birth control, but since I was diagnosed with bipolar it's just not been an option. I hadn't even known that about Lamotrigine, though - it's one of the six(!) medications I'm on right now, so the more I know the better, I guess.

  2. Yup.. I hear that. Not one, but two giant blood clots are why I can't take the pill, and haven't been able to since I was 18.

    Although I'm all for readily accessible contraception, there are some problems with the history of the birth control pill. Compared to other drugs, the time it took between it's conception (nyuk), development, testing phases and being introduced to the market was only 12 years which is a relatively short time.

    We're the first generation of women who were pretty much on B.C from puberty, and we're raising the first generation of little girls born to women on B.C... and sometimes I wonder if we're only seeing the tip of the iceberg in effects of this pill.

  3. I've been off hormonal birth control for several years and using condoms as my primary birth control. After an "oops" and my abortion this summer, I decided to get an IUD. I was worried too. I've heard the horror stories about killer cramps and super heavy periods. After having it only 3 months though, I love my IUD.

    For me, the best part is being able to have sex where ever, whenever, with out thinking about birth control. I think this must be how men feel about sex. Since I'm with stable partners and STDs aren't a concern, sex is finally a no-hassle fun thing to do! The liberation I'm experiencing far outweighs the minor increase in cramps and bleeding.

    I've been recommending the IUD to my friends. I know my experience is not necessarily typical, but I really think the advantages of the IUD haven't been celebrated enough!