But baby, it just won't feel as good.
October 7, 2014 1:06 PM   Subscribe



 
Funny, but the paper gown ties in front, not in back. Just for extra fun.
posted by muddgirl at 1:11 PM on October 7, 2014 [4 favorites]


excellent
posted by janey47 at 1:14 PM on October 7, 2014


I appreciate this effort, but I don't think anything will ever really capture how brutally, terribly awful I find it to be to go to the doctor. They included the physical discomfort of an exam, but I don't think there was enough about HOW AWFUL it is to go to the doctor as a woman. I mean, she didn't even tell him he had to lose or gain weight or threaten to withhold his pills if she didn't approve of his lifestyle choices! She didn't question everything he said and dismiss his accounting of his symptoms and needs! What kind of doctor is THAT? To be honest, in terms of actual patience experience, this kind of seems like an improvement.
posted by Mrs. Pterodactyl at 1:15 PM on October 7, 2014 [66 favorites]


Plus, no added benefit of spending hundreds of dollars out of pocket if you want a form of birth control that isn't covered, if you need to go out of the country and can't "just come back in three weeks," having to set really awkward alarms and needing access to your medicine/water/privacy at the same hour every single day, or being slut shamed in the news when you find out that many small businesses, large organizations, and elected officials think your medicine makes you a strumpet who doesn't deserve birth control because a) you could have sex ?!?!?! and b) there are definitely no other medical reasons like your skin, mental health, and pain relief why you would want hormone-controlling pills!

but yes this is a humorous video and it is hopefully useful in explaining why the whole process in America is AMAZINGLY ARCANE AND TERRIBLE
posted by jetlagaddict at 1:24 PM on October 7, 2014 [4 favorites]


I mean, she didn't even tell him he had to lose or gain weight or threaten to withhold his pills if she didn't approve of his lifestyle choices!

My personal favorite: "Why are you even on the pill? Are you just on the pill because you think that if you're anorexic and on the pill, it will protect your bones? IT WON'T. And you know, if you ate more, your breasts might be larger even without the pill!"

Side note: wasn't anorexic. But thanks, helpful nurse!
posted by jetlagaddict at 1:30 PM on October 7, 2014 [1 favorite]


Birth Control is sometimes colloquially used to mean hormonal birth control, or birth control pills, which require a doctor's prescription in the United States.
posted by muddgirl at 1:31 PM on October 7, 2014


They've forgotten the part where he asks about a vasectomy and the doctor just laughs and laughs and laughs, and never answers the question.
posted by like_a_friend at 1:38 PM on October 7, 2014 [48 favorites]


At my last visit to the OBGYN, I had a very earnest resident who was having a very hard time getting the freaking speculum in properly. About 6 minutes into the process, he said "Hey, has anyone ever told you have a tipped uterus?" and I said "No, but nobody's ever spent that much time looking before!" and he got huffy while wiggling the speculum around even more vigorously for another couple of minutes before finally getting it to do whatever he wanted it to.

The side eye I got from the pharmacist the one time I went to responsibly get Plan B is one of the only things that makes regular visits to the OBGYN worthwhile. I suppose I'd rather have someone poke me in the cervix once a year than get judged every time I go to the grocery store.
posted by ChuraChura at 1:40 PM on October 7, 2014 [2 favorites]


The video could have acknowledged the crazy side effects that can come with birth control. Sure, condoms can make sex feel worse, but hormonal birth control can make everything feel worse! Yaaaay!

Are you just on the pill because you think that if you're anorexic...

That came out of an actual human being's mouth?? Holy shit. On behalf of humanity, I am so, so sorry.
posted by evidenceofabsence at 1:41 PM on October 7, 2014 [9 favorites]



They've forgotten the part where he asks about a vasectomy and the doctor just laughs and laughs and laughs, and never answers the question.

No, the doctor smiles condescendingly and says:

- you'll change your mind when you're older, honey, when the hormones kick in
- i think it's a little early to talk about that, don't you?
- i don't feel comfortable having that conversation without your wife present
- you're not even married, how will you get married if you can't have kids?
- here is a sharp piece of plastic we can implant in your nutsack that will make you emotionally crazy and could fall out and your partner may feel it during sex and you will bleed when we put it in
posted by poffin boffin at 1:42 PM on October 7, 2014 [57 favorites]


I am all for making the process for getting lady-focused birth control easier, but it bugs me that the Right has picked up on "let's just make birth control available over-the-counter!" as a supposedly lady-friendly way around the no-copay mandates of the ACA.

And so I worry that pieces like this are just playing into that agenda.
posted by sparklemotion at 1:46 PM on October 7, 2014 [10 favorites]


I might be part of a drug trial and one of the questions I was asked (besides the usual "are you on any birth control?") was "Are you still of childbearing age?". My response, "I am trying hard not to be."
posted by Kitteh at 1:49 PM on October 7, 2014 [5 favorites]


After years of horrible doctors ("did you know that you don't pee out of your clitoris?" "uh, yes") I was very pleasantly shocked the day my 26 year old childless self went into a brand new gyn and said "I want an IUD" and she said "OK, here are the kinds, what do you want?" I was so ready for a fight that I was actually struck completely speechless for a solid 20-30 seconds.

That was a completely perfect only good experience, and more than anything else just highlighted how completely and utterly fucked these things usually are.
posted by phunniemee at 1:50 PM on October 7, 2014 [10 favorites]


Are you absolutely sure the first example wasn't an escaped mental patient in a stolen pair of scrubs?
posted by poffin boffin at 1:53 PM on October 7, 2014


Also I'm at the doctor's office right now for a (non-ladybits) checkup and on the info form where it asks if I'm currently being treated for any medical conditions I checked "yes" and filled in "having babies."
posted by phunniemee at 1:53 PM on October 7, 2014 [13 favorites]


That sounds like doctors are struggling to find a cure for a disease which you have that makes babies just fall out all the time, like when you sneeze.
posted by poffin boffin at 1:54 PM on October 7, 2014 [31 favorites]


Birth Control can be a prescription drug and yet not require an annual visit, or more importantly, an annual pap smear. Especially in populations where an annual pap smear is not medically necessary.
posted by muddgirl at 1:55 PM on October 7, 2014 [6 favorites]


Once when I went to a new doctor to get birth control pills renewed, the very next thing he asked when I said I needed a prescription for the pill was if I was married. I did not go back to that doctor.
posted by lollusc at 1:57 PM on October 7, 2014 [2 favorites]


And this is like two years ago in Australia, not 1910 in Ireland or anything.
posted by lollusc at 1:57 PM on October 7, 2014 [8 favorites]


a disease which you have that makes babies just fall out all the time, like when you sneeze

omg you have literally just inadvertently stumbled upon my greatest fear.
posted by phunniemee at 1:59 PM on October 7, 2014 [20 favorites]


like the sorcerer's apprentice except the brooms are babies and instead of cleaning stuff up they just cry and poop
posted by poffin boffin at 2:01 PM on October 7, 2014 [12 favorites]


and instead of a robe and wizard hat you are wearing an obnoxiously scratchy paper gown and a huge diaphragm on your head
posted by poffin boffin at 2:02 PM on October 7, 2014 [3 favorites]


Are you absolutely sure the first example wasn't an escaped mental patient in a stolen pair of scrubs?

Yes but I do think he might actually have been the inspiration for Dr. Hibbert.
posted by like_a_friend at 2:03 PM on October 7, 2014


There are obviously lots of problems with things women have to put up with from doctors and doctors' offices - as this thread is documenting very nicely - but I don't think this is necessarily the way to go about highlighting them.

Buying condoms isn't like buying birth control because a condom is a little piece of latex you put over your penis for 20 minutes that doesn't induce any massive chemical changes in your body. They aren't, you know, pharmaceuticals. If you're going to give people who are resistant to the idea of male privilege that easy of an out, all you're doing is preaching to the choir. Then again, since this is a comedy video, maybe that's all it's trying to do.
posted by mellow seas at 2:04 PM on October 7, 2014 [8 favorites]


(I have gotten all of the other insulting and infuriating reactions as well, but the laughing one kind of did beat all. In the end I just basically gave up and resigned myself to pills, although now that they've stopped helping with my acne and i am finally An Old, I might try again...)
posted by like_a_friend at 2:05 PM on October 7, 2014


Birth control is available over the counter in a lot of countries though, and even in countries where you need a prescription like England, it's a substantially easier and less expensive process. The point isn't that there shouldn't be any oversight whatsoever, it's that the process here is substantially more difficult than it has to be, and it's often packaged with archaic and parochial views on health. When I went JYA in college, it was standard advice that if you were studying in the UK and if you told them you were an American, most doctors would go out of their way to make sure you had extra packs to take back home because they knew how hard/expensive it was for most students.
posted by jetlagaddict at 2:10 PM on October 7, 2014 [13 favorites]


Oh, yeah, no doubt that things in the US are set up to shame and inconvenience any woman who wants to have non-procreative sex. I didn't realize OTC birth control was common in other countries. And, yeah, you can buy plenty of stuff over the counter in the US that will kill the shit out of you if you take enough.
posted by mellow seas at 2:13 PM on October 7, 2014 [3 favorites]


They aren't, you know, pharmaceuticals.

Perhaps they should have made it, "If buying Aspirin was like buying Birth Control."
posted by muddgirl at 2:38 PM on October 7, 2014 [14 favorites]


even in countries where you need a prescription like England, it's a substantially easier and less expensive proces

Yes. When I used the contraceptive pill, I needed a doctor's appointment every - 3, I think? - months, but it never involved more than "Everything fine?" "Yep" and checking my blood pressure. Cost: zero, because it's a contraceptive.
posted by Catseye at 2:54 PM on October 7, 2014 [2 favorites]


"Also I'm at the doctor's office right now for a (non-ladybits) checkup and on the info form where it asks if I'm currently being treated for any medical conditions I checked "yes" and filled in "having babies.""

RAGE STORY TIME!

I go to a Catholic-hospital-affiliated GP and ob/gyn, because most of them are around here (and I am, in fact, Catholic). Their deal is, the nuns who own the hospital allow doctors to prescribe birth control, but the doctors have to pay for a separate malpractice insurance policy (which comes to something like $28/year) and write the script on separate Rx pads. Silly, but everybody's happy.

So I call my GP to get some birth control after popping out a couple of babies, which has never been a problem before. And her nurse is like, "Oh, okay, sure, and what do you need the birth control for?"

"... to not get pregnant."

Awkward silence.

The nurse coughs and says, "No, I mean, I need what medical condition do you need it for, like acne? Or really bad cramps, maybe? Your periods are too heavy?" in a very helpful sort of voice.

And I'm like OH FUCK THIS I KNOW WHAT THIS IS because I went to Catholic college and I am VERY FAMILIAR with the thing where Catholic doctors are allowed to prescribe birth control as a medication for hormonal problems but not a birth control. So I said, "The medical condition is, I do not want to get pregnant."

She said, "Um, we need a medical complaint or we can't give it to you for that anymore? You can just make something up?"

"Yeah, I'm not going to make something up."

"Our insurance doesn't cover it because the paperwork got to be too much and we're seeing a lot more seniors these days, and the nuns won't let us give it to you for birth control on their insurance ... but I can give you the number for Planned Parenthood and you can get it free from them!"

"So the brilliant plan here from the local Catholic authorities is to send married Catholic mothers of two looking for simple birth control to Planned Parenthood? Really?"

"Really," she agreed in a tired voice that said she knew how dumb this was.

I told her I'd call my ob/gyn, which I did, and the nurse said, in an extra-cheerful voice, "Oh, sure, no problem! I see on your chart we've given you ortho-tri-cyclen in the past, I'll have the doctor write up a script for you just as soon as you come in for your pap smear, we haven't seen you in 18 months!" And I was like OH GOD DAMN IT and remembered why I hadn't called my ob/gyn in the first place. (So I went and got the pap smear and my birth control and it was not a big deal but GRAR.)
posted by Eyebrows McGee at 2:59 PM on October 7, 2014 [33 favorites]


THERE ARE COUNTRIES WHERE YOU CAN GET BIRTH CONTROLS OVER THE COUNTER?! Mind officially blown.
posted by AlexiaSky at 3:07 PM on October 7, 2014 [2 favorites]


and a huge diaphragm on your head

Good news! I think I've figured out why babies keep happening to you!
posted by emjaybee at 3:10 PM on October 7, 2014 [25 favorites]


Related: routine pelvic exams may be unnecessary.
posted by Librarypt at 3:12 PM on October 7, 2014 [1 favorite]


Completely related, Librarypt. Even on point. In America access to birth control is routinely held hostage to a pelvic exam that's of questionable screening value, much less medically necessary for monitoring the side effects of birth control.
posted by muddgirl at 3:31 PM on October 7, 2014 [12 favorites]


Oh man when I was JYA in Brazil, and the pill was OTC and cheap cheap cheap, I stocked up before coming home. I basically looked for the packages with the furthest out expiration dates, and then bought a package for every month between that month and the date of expiration on the packages. I think I came home with nearly three year's worth of pills, for like $23. But making it cheap and easy is somehow a terrible idea.
posted by ambrosia at 3:42 PM on October 7, 2014 [2 favorites]


it bugs me that the Right has picked up on "let's just make birth control available over-the-counter!" as a supposedly lady-friendly way around the no-copay mandates of the ACA.

Wait, why is this a problem? That sounds fucking amazing. I would rather drink a bottle of vinegar sometimes than visit the OB-GYN. It is universally an awful experience, and was only okay the year I was pregnant and had midwives.
posted by corb at 3:43 PM on October 7, 2014 [1 favorite]


Terry Gross had a great show today about the birth of the birth control pill. The hurdles that went into developing it are pretty amazing. Now it's been around for over 50 years and is still controversial.

Of course it's controversial! The pill has been (and was designed to be from the start) one of the biggest (perhaps THE biggest) tool for freeing women from the power of men. The entrenched power structures never liked it, and though they're in retreat, they haven't been beat yet.

It makes me sick to hear all the stories of horrible doctors. I promise to give extra to Planned Parenthood this year. God bless Margaret Sanger!
posted by rikschell at 3:46 PM on October 7, 2014 [16 favorites]


I think because OTC costs would be 100% covered by the individual and instead of being 10$ or free they would prolly be like $50 or something.
posted by poffin boffin at 3:47 PM on October 7, 2014 [2 favorites]


Does it have to be, though? There's some OTC that my insurance pays for because it's cheaper than the result of me not buying it would be. I'd think birth control would fall under that.
posted by corb at 3:48 PM on October 7, 2014


Then again, I'm not a dude who wants ladies to keep their legs closed, so I am probably failing to appreciate how awful they can make everything.
posted by corb at 3:48 PM on October 7, 2014 [1 favorite]


IDK but I would err on the side of "insurance/pharma company will be a piece of shit about this" rather than "this will be done easily and cheaply" because lbr that is basically their goal.
posted by poffin boffin at 3:49 PM on October 7, 2014 [7 favorites]


You'd think that pharmacists would be willing to turn a blind eye and just sell you the stuff. I've been doing that for a decade and a half with insulin, ever since I got too lazy to go back to the doctor to get a refill. (That was after, like, the second time.) I just say, "I need such-and-such insulin, and could you also give me an official written prescription receipt so that I can submit it to my insurance company?" And I've never once, in a couple of hundred visits to various pharmacies, been challenged on it.

Does this tactic seriously not work for something as basic as birth control pills? Oy.

(I enjoyed the video, BTW; very eye-opening, and the discussion even more so.)
posted by clawsoon at 4:11 PM on October 7, 2014


Oh, and the insurance companies have never given me any grief for it, even though all the supplies add up to a couple of thousand dollars per year.
posted by clawsoon at 4:14 PM on October 7, 2014


There's a number of reasons why the OTC feint is bad news:

1) As mentioned, it's an end-run around co-pays and selection, because the ACA designates it as preventative care and therefore the costs lie with the insurer. Taking that away would have a huge negative effect, especially on low-income women. This is not by accident.

2) Only hormonal birth control would be OTC, not emergency contraception, because of course only loose women need Plan B (and also because personhood).

3) It wouldn't apply to IUDs, for obvious reasons (and also more personhood nonsense).

So, yeah, still all about controlling women's sexual freedom and punishing them for wanting sex outside of procreation.
posted by zombieflanders at 4:27 PM on October 7, 2014 [8 favorites]


It still blows my mind how fucking ridiculous the system is. I have to funny memories from high school and the beginning of college relating to this.

The first one, is that my friend i was living with at the time got his tonsils out and they gave him a gigantic bottle of liquid narcotic painkiller. Like, imagine the BIGGEST nyquil/benedryl/etc bottle you've seen and add another 6-8 ounces. It was like a 24oz beer can of painkiller syrup. Later on we all joked that he should call up and see if he can get it refilled. They did it over the phone without asking any real questions. This was in the 2000s, after all the ridiculous regulations, and this is a ZOMG CONTROLLED DANGEROUS SUBSTANCE according to the government. The kind of thing they hesitate to prescribe to people who really need it, supposedly. And he got a courtesy jug, no questions asked.

Inversely, my not-18 girlfriend getting birth control was a fucking nightmare. We had to bus across town on a weekday, during stupid hours that overlapped with school to a completely inaccessible area and then walk to a weird clinic. Then they did the entire stupid pelvic-exam-as-gatekeeper thing and the entire process with the office made it feel like she was buying a fully automatic rifle. Refills also involved dealing with that weird clinic.

I mean yea, she wasn't 18, but realistically tylenol has more serious side effects and they don't even card you at the store to buy that. There's plenty of things at your local walgreens that are more dangerous. The entire process was blatantly crafted to disenfranchise people and discourage them from getting it.

The only cool upside was that it was really cheap and funded by some state program or charity, but holy shit what a hassle.

What in the fuck is wrong with this country. I mean, i know the answer to that question, but still... ugh.
posted by emptythought at 4:29 PM on October 7, 2014 [4 favorites]


"If buying condoms WERE like buying birth control." Subjunctive ftfy the struggle is real.
posted by Zerowensboring at 4:43 PM on October 7, 2014 [12 favorites]


The doctor forgot to ask him how many sexual partners he's had.

Oh what, doctors don't need to ask that to prescribe the pill? Tell that to every doc who prescribed it to me when I was in high school. In the 90s.

Seriously, this video barely scratches the surface of the levels and variety of bullshit involved for women to have sex and prevent pregnancy, but I really appreciate that they tried. Well done. Good post!
posted by juliplease at 5:13 PM on October 7, 2014 [7 favorites]


The doctor forgot to ask him how many sexual partners he's had.

And how many of which gender, no less. *angry grumbling*
posted by dialetheia at 5:19 PM on October 7, 2014 [3 favorites]


Um, a sheath, whether worn by a male or a female isn't a hormonal treatment. The answer is that if hormonal birth control is used it should be covered by national health insurance in conjunction with medical care. Getting people to the doctor generally helps - whatever the cause for the visit.

Hormonal contraceptives have a well esablished risk to women, especially among women who also smoke, as do all methods of birth control that target the reproductive systems of women.

Also from Huffpo Side Effects May Include Death: The Story Of The Biggest Advance In Birth Control Since The Pill

The answer is to bring people to a doctor, not for people to act as their own doctor.
posted by vapidave at 5:23 PM on October 7, 2014 [2 favorites]


My takeaway from the video (aside from chuckles) was the bit at the end, where the man asks the woman if she can take care of the birth control, and she just brushes it off. I don't think it was trying to make the point that condoms and contraceptive pills are the same thing (medically). I think it was saying just the opposite.

And yeah, it had plenty to say about unnecessary shaming and discomfort.
posted by dumbland at 5:30 PM on October 7, 2014



Geez, I'm over 40 and have been regularly getting birth control since high school. Even had to get the morning after pill a couple of times and the only thing the doctor was concerned with was risk for STDs. I've never had anything like all this happen. This is with multiple doctors too. The closest I got to feeling any bit of shame or uncomfortablness was with my last doctor who during my physical wanted to make sure that if I wasn't planning to have kids with my husband that I had the whole BC thing covered to my own satisfaction and that was more because of the state of that part of our life. I don't recall my sisters or friends ever talking about issues either.

I'm in Canada. I know issues with women's reproductive health are messed up in the US relative to other countries but I still get surprised at how seemingly different they are. Unless my experience is really outside the norm up here of course.
posted by Jalliah at 5:44 PM on October 7, 2014


Okay, language question time: when I lived in the states, the pill was called "the Pill", and was a form of birth control. Condoms were also a form of birth control. Now, apparently, "birth control" means "the pill", so what's the generic word for "pregnancy prevention mechanism"?
posted by Bugbread at 5:46 PM on October 7, 2014


Contraceptive.
posted by zombieflanders at 5:49 PM on October 7, 2014 [1 favorite]


Getting people to the doctor generally helps - whatever the cause for the visit.

Then it's a great idea to make all drugs prescription-only, so that people go to the doctor more!

Birth control pills are pretty damn effective at preventing one of the most dangerous things that can happen to a woman. There are side effects, just like there are side effects to OTC allergy medicine and pain killers. Maybe the side effects warrant a yearly visit with a doctor, but no one has been able to explain why this needs to be tied to a pap smear and pelvic exam as well, except "for our own good." Like women are children who need to be bribed to get appropriate medical care.
posted by muddgirl at 5:55 PM on October 7, 2014 [12 favorites]


Perhaps you missed the sentence immediately prior. "The answer is that if hormonal birth control is used it should be covered by national health insurance in conjunction with medical care."
posted by vapidave at 6:04 PM on October 7, 2014


I'm in Canada. I know issues with women's reproductive health are messed up in the US relative to other countries but I still get surprised at how seemingly different they are. Unless my experience is really outside the norm up here of course.

I'm in Canada too. This was my experience discussing birth control with my former doctor, just three years ago. Now I'm not saying this is typical of doctors in Canada or anything (and in fact, my general experience has been the opposite). But it was still super weird to be 32 years old and living in a developed country and still having to justify my reproductive choices to some middle-aged man while he gave me the Disapproving Dad routine. Anyway, it's not something I ever expected to experience in this day and age where I live, but there you have it.
posted by futureisunwritten at 6:05 PM on October 7, 2014 [1 favorite]


Perhaps you missed the sentence immediately prior.

I didn't miss it, but I didn't see a scientific justification for doing so beyond "hormones can be dangerous." So can naproxen and I take that over the counter.
posted by muddgirl at 6:17 PM on October 7, 2014 [2 favorites]


As a non-lady person I'm still a little confused why IUD's aren't in broader use. Everything I've read about them basically says they are more effective, cheaper and have fewer side-effects.
posted by elwoodwiles at 6:39 PM on October 7, 2014


Also as a non-lady person, the most trouble I had buying condoms was when I was with my lady person. We have to go to the pharmacy window at the grocery store for some reason. As I'm checking out the cashier asks if I have a safeway card. I don't, and I'm not feeling like signing up while buying a pack of condoms so I just say no. My lady person then jumps in with "I do!" and starts digging around her purse, causing an awkward delay. Then, if this hasn't become embarrassing enough they start having a conversation... about me... while I'm standing there. "Yeah, my boyfriend hates using the discount cards too." "Oh I know, men, sheesh..."

"sigh"
posted by elwoodwiles at 6:43 PM on October 7, 2014 [1 favorite]


Various reasons include:

- you have to have a doctor insert it and then remove it when you decide you want to try for pregnancy
- hormones released by the hormone releasing ones can be very unpleasant
- they can be very painful and cause bleeding between periods
- many doctors give you a hard time about getting one if you have never had a baby before even if you say that you do not ever want a stupid baby ever not even in one billion years
- some people (me) are super creeped out by the thought of having a plastic thing stabbing around inside their uterus all the time
posted by poffin boffin at 6:44 PM on October 7, 2014 [8 favorites]


As a non-lady person I'm still a little confused why IUD's aren't in broader use.

Just the idea of having that thing stuck in me...NOPE NOPE NOPE. I'm so thankful women who want them can get them, but no fucking thank you, I will happily eat my pill every morning.
posted by gatorae at 6:57 PM on October 7, 2014 [1 favorite]


I'm in Canada. I know issues with women's reproductive health are messed up in the US relative to other countries but I still get surprised at how seemingly different they are.

There isn't a shortage of people wanting to make it messed up here, either. The Wild Rose party tried to sneak "ethics rights for medical professionals" into their platform a few years ago. Shortly before the election someone in the media clued in to what they meant and the party ended up nixing that plan. For now.

I would not be surprised it they raised it again if/when they ever get a majority. Sigh, Alberta.
posted by CKmtl at 7:01 PM on October 7, 2014 [1 favorite]


"So can naproxen and I take that over the counter."

I don't think naproxen should be OTC either.

I'm arguing for, as I said "national health insurance in conjunction with medical care."
posted by vapidave at 7:08 PM on October 7, 2014


Why Don't More American Women Use IUDs?
Although long-lasting reversible contraceptive methods (LARCs) like IUDs are pretty popular in Europe (27 percent of Norwegian female contraception users have one) and China (41 percent!), only around 8.5 percent of women in the United States choose these as their birth control method, among the lowest of any developed country, according to a recent report by the Guttmacher Institute. But while at least half of my girlfriends now have IUDs, some of them have had to jump through hoops and even lie to convince their doctors to prescribe them one. Why has it been hard for young women in the United States to get their hands on this type of birth control?

The American stigma against IUDs almost certainly traces back to a scare in the '70s and '80s surrounding the Dalkon Shield IUD, a poorly designed device that wicked bacteria up its string and sometimes resulted in infections, septic miscarriages, and even death. (Mother Jones reported on it back in a 1979 issue.) In the years after the controversy, reported Adam Sonfield of the Guttmacher Institute, "the media trumpeted a series of studies linking the Shield and other IUDs to pelvic inflammatory disease and subsequent infertility." IUDs since have been reengineered and deemed safer, but physician and consumer mistrust has lingered.
There was also an assumption for a while that women who had not given birth would have physical difficulties with the insertion of an IUD.
posted by jaguar at 7:12 PM on October 7, 2014 [10 favorites]


As a non-lady person I'm still a little confused why IUD's aren't in broader use. Everything I've read about them basically says they are more effective, cheaper and have fewer side-effects.

They're great contraception, but insertion can be pretty uncomfortable, they can be quite costly (and that cost is up-front rather than spread out month by month), you need a special appointment to insert them (which carries a separate cost), and, depending on the IUD type and the woman, heavy and/or unexpected bleeding can be a problem for the first few months (a particular difficulty for members of religions with proscriptions against sexual or other behaviors during menstruation but also for women who enjoy swimming or wearing white pants).
All that acknowledged, IUDs certainly should be in broader use than they are in the US, and a major reason they aren't is that American clinicians often have outdated information about the safety of IUDs and their ease of insertion (although both the American College of Obstetricians and Gynecologists and the American Association of Physicians have recently endorsed the use of long-acting reversible contraceptives, including IUDs, in adolescents, including nulliparous ones, so maybe the word will finally get out.)
posted by gingerest at 7:40 PM on October 7, 2014 [2 favorites]


This is so timely. Today I went to the pharmacy to pick up my normally free birth control and instead, the charge was $90. Now, granted, this is because my insurance is weird and likes to make you fill your prescriptions by mail and not because of some hatred for birth control but regardless, the idea that a month's supply of bc could or should cost that much is ridiculous. Even more ridiculous was when I called my insurance provider and they informed me that they wouldn't be able to send me the pills until 5-8 days after they received the new prescription and the customer service rep asked if I could get some pills from the pharmacy just to "tide me over." I explained that no, it was birth control, so that wouldn't be possible. He repeated that maybe the pharmacy could give me a partial fill "or something." Me: "No, it's birth control. It comes in a package with a month's supply. They can't do that." Him: Total silence.

And even the most well-meaning partners can be super annoying when you forget to refill a prescription.
posted by Polyhymnia at 7:43 PM on October 7, 2014 [3 favorites]


As far as refills go, I find it hard to believe that any pharmacies on any significant scale are filling prescriptions without e-rx / faxing in a refill request to your physician. If your doctors' office is very accommodating and quick and your pharmacist seamlessly handles this it can seem like an awesome flawless experience.

Often the physician's office has surprisingly low-level staff handling prescription refill authorizations and things like insulin shouldn't raise any more attention than an immediate "OK," and I'm sure there are informal "standing orders" and stuff in smaller towns / less corporate pharmacies, but this stuff is pretty heavily regulated at this point. On the other hand, it's easier for non-physicians like PAs and NPs to prescribe drugs, but this is to the benefit of society insofar as we can access a less expensive resource for routine things.

The pelvic exams and pap smears and overall demeaning behavior is terrible. Requiring women to come in every year is a cash-cow thing, though evidence-based medicine probably will show some benefits in terms of cardiovascular health which could just as easily be caught with regular visits to any medical practitioner (doctors of any sort should be comfortable doing blood pressure in this day and age, for example, and should just check that and a few things even if you're seeing them for a foot problem, and that's one of the intentions of Electronic Medical Records + Meaningful Use incentives).

Now, I require a few routine things like a yearly albuterol script, nasal spray, etc. The doc actually pushed nasacort on me instead of my preferred nasal allergy med despite it being the most expensive option on my insurance. Instead I dropped to generic flonase ($4 Rx) until Nasacort became OTC.

My primary care doctor is exactly the same way about insisting on routine visits in order to fill scripts that should just be written 1-5 years in advance -- except I'm a dude and nothing goes inside my body (typically). I do get a hard-sell from the medical staff that I need to come in every 6-12 months in order to get my meds filled. Luckily my favorite nasal spray is OTC, I can get it for $15/mo now, but realistically more people would be better off with the generic $4-10 flonase covered by health insurance. I just had a problem with it being too aggressively drying.

This is not at all an equivalency, just sharing my experience with docs being pushy about getting their E&M revenue up for the month. E&M is "evaluation and management" and for a lot of docs who see the highest volume of patients, it doesn't pay all that much so naturally the quality of the service drops, they pursue "sales" aggressively and drive people away, etc. My p-doc is the same way, it's a very friendly good relationship but I can't go more than 2-3 months without seeing her if I want to have a smooth continual series of refills.
posted by aydeejones at 7:48 PM on October 7, 2014


Pure "E&M" docs are basically non-surgeons and it's not a bad thing that they pursue this often thankless, low-paying job of being a more general (PCP, GP, internist, etc) or conservative-treatment doc. But a lot of them are basically just pumping up as many $25-100 visits (after copay, etc) as possible for as few minutes per visit (3-5 at a time maybe for non-new-patients) as possible.
posted by aydeejones at 7:52 PM on October 7, 2014


elwoodwiles, not to derail too much or anything, but there was a great askme a few years ago where many many women responded with their personal stories of IUD insertion, pain levels they experienced, and the types of pain relief they were offered. It should offer some insight into what getting an IUD can be like, and certainly some of the issues highlighted in this video play a part in why fewer women in the US opt to have them placed.

Here's the AskMe
posted by Polyhymnia at 7:53 PM on October 7, 2014 [2 favorites]


As a non-lady person I'm still a little confused why IUD's aren't in broader use. Everything I've read about them basically says they are more effective, cheaper and have fewer side-effects.

You ever had a catheter inserted up into your urethra? Or anything inserted into your urethra?

Imagine that feeling, except taking place Deeper inside your body. Personally, there is not enough NOPE in the world.
posted by EmpressCallipygos at 7:56 PM on October 7, 2014 [2 favorites]


Physicians are liable for the medications they're prescribing, in addition to just caring about whether the medications are working for their patients, so I don't think it's unreasonable for physicians to want to lay eyes on patients who are under their care.

Pelvic exams and pap smears are not related to birth control pills, though, which is the issue in my mind. I don't think it's wrong to want a patient to come in yearly to make sure they're doing ok on a prescription, but I do think it's wrong to require an invasive exam before refilling a prescription for a medication that doesn't require an invasive exam.
posted by jaguar at 8:21 PM on October 7, 2014 [2 favorites]


Nthing everyone upthread who's said that this is the bare minimum of how inconvenient it is, not even remotely close to how actually inconvenient it is.
posted by Sara C. at 8:34 PM on October 7, 2014


You ever had a catheter inserted up into your urethra?

I've had a catheter and an IUD. They went different places. The IUD did not hurt.

(Migrated around later on its own, but that's a different story)
posted by BlueHorse at 8:43 PM on October 7, 2014 [1 favorite]


Only hormonal birth control would be OTC, not emergency contraception

Emergency contraception is OTC, which is one of the main points in favor of making all hormonal birth control OTC.

Also, since folks are already paying insane copays -- if your insurance even covers the pill in the first place -- to me it makes no real difference whether I'm paying the $30-50/month as a "copay" or as just paying money for a product. If birth control was already free and universally available under the counter, and bringing it OTC was going to cause a major change in costs, sure, that would be bad. But since that's not the situation, who cares?

Especially considering the fact that, in order to get prescription birth control, you need a doctor visit and most likely health insurance in the first place. Keep it prescription-only and you absolutely bar the vast majority of low income people from accessing it even if it's completely covered by insurance with no copay. Make it over the counter but $40/month, and it becomes accessible to people who have $40 a month but not $200 for a doctor visit, or $500/month for insurance.
posted by Sara C. at 8:46 PM on October 7, 2014 [4 favorites]


My husband was prescribed methotrexate for an autoimmune disorder, and before they would write him the prescription, they made him talk about what we were using for birth control. (Methotrexate is horrifyingly fetotoxic.) He was SUPER INDIGNANT about it until he realized that I, as a woman, get asked that question at the beginning of every single doctor's appointment ever.
posted by KathrynT at 8:49 PM on October 7, 2014 [5 favorites]


it bugs me that the Right has picked up on "let's just make birth control available over-the-counter!" as a supposedly lady-friendly way around the no-copay mandates of the ACA.

It's obnoxious because the same people pushing this idea right now have fought as hard as they can for years now to make access to every form of contraceptive and abortion more difficult. It's not that making the Pill OTC is a bad idea, it's that it's so transparently a pre-election "pay no attention to the [war on women] behind the curtain" move that I would be happy if we table any discussion on the subject until after election day.

My household has been receiving his-and-hers mailings from my state's Republican candidate for the US Senate for the past couple of months. By which I mean that the ones addressed to my male partner talk a lot about fracking and how evil liberals are, and the ones addressed to me are all about how this candidate is Really Into Women's Rights, and the only evidence for that is that he supports making the Pill OTC. Which I am pretty sure he has been in favor of for nearly six months now.

Should I meet him in the next month, I'll tell him: "You're running for Senate, not the FDA. Pull the other one, you ACA-opposing, personhood-amendment-supporting bag of brined buttholes. It's got goddamn bells on."

So, yeah. Let's talk about lobbying the FDA to make the Pill available over-the-counter sometime in mid-November. Just as soon as it's not playing into the hands of someone who wants me to believe he's outraged that I have to get a prescription written to get my now-free-of-charge birth control pills, while he's really working hard to ensure that I won't have any way to get prescriptions written for anything at all.
posted by asperity at 8:53 PM on October 7, 2014 [5 favorites]


If we're trading Canadian anecdotes, I too a Canadian and find all these stories (including the one upthread from the Canadian) unbelievable. I mean I believe them but somehow I just can't fathom this happens to people. I have contraindications for the pill, so I've not tried to get it, but my doc is pretty open about these things and non-judgy. She does do the pap every 3 years (if you've had two? or three? normals in a row, the new guidelines say you can go every 3 years), but I'm not particularly bothered by that. I mean it's not comfortable, but it's hardly the least comfortable thing a doctor has done to me. She has reminded me that Plan B exists and how to get it (and also reminded me of my contraindications and the things to watch for if I ever took it). She does ask about partners, but I believe this is because new partners increase the risk of UTIs, not because she wants to get all in my business. To the extent she gets all in my business, it's to remind me to take precautions if I am so inclined, not to try to judge me out of doing so.

I can't imagine seeing a doctor who did not treat me with basic respect and not just switching doctors. I guess I don't understand how these doctors just not have any patients. I mean I believe, it, but I don't get how.

Kathryn: Serious question, doesn't every doc ask every patient what medications they take? I would think it would be irresponsible not to. It's weird that they would ask about one medication in particular, though, instead of just asking for the list.
posted by If only I had a penguin... at 8:57 PM on October 7, 2014 [3 favorites]


If only I had a penguin...: " It's weird that they would ask about one medication in particular, though, instead of just asking for the list."

Generally the thrust of the questioning is, "Is it remotely possible you're pregnant?" rather than "What medications are you taking?"

On the one hand, I get it, you don't want to accidentally give a pregnant woman thalidomide or accidentally cause her fetus to abort, that is tremendously expensive for your malpractice insurance. On the other hand, if your answer is, "I haven't had sex in literally 18 months AND I am on hormonal birth control," they will still make you pee in a cup before giving you an MRI to make sure you're not pregnant before they harmlessly scan you.

As I lawyer I understand the liability issue, but as a woman it makes me SUPER GRUMPY especially when it means your concussion visit to the ER lasts an extra two hours for the pregnancy test to come back before you can get the CAT scan that would be LITERALLY TOTALLY HARMLESS ANYWAY.

I was an MRI test dummy in law school, I got paid $30/hour to let the MRI students scan my brain, and an extra $10 before every MRI to have them draw my blood and make sure I wasn't pregnant. Every. Single. Time. I mean it paid for my parking but STILL.
posted by Eyebrows McGee at 9:13 PM on October 7, 2014 [2 favorites]


I don't think naproxen should be OTC either. - me, vapidave

Why exactly?

Because it's a dangerous drug. Please bear in mind that I'm arguing in the context, as I said above, "I'm arguing for, as I said "national health insurance in conjunction with medical care."
posted by vapidave at 9:21 PM on October 7, 2014


The exact cost seems to randomly (and infuriatingly) change but the last time I picked up my partner's birth control pills for her it was $120 after insurance. Yes, there are cheaper options, but this one hits the amazing sweet spot of minimal side effects and maximum control of other issues, so even if it was $1200 we would find a way to pay for it. And she has an amazing doctor, which means she has someone to write the appeals to the insurance company every time they want to change her prescription to a cheaper alternative -- right now that is once a year, but for a while it was quarterly, which is beyond crazy.

The video hints at a few of the indignities that women have to go through to access normal health care, but as others have said the reality is so, so much worse.
posted by Dip Flash at 9:26 PM on October 7, 2014 [1 favorite]


As a non-lady person I'm still a little confused why IUD's aren't in broader use.

Insurance may not cover them even if it covers other birth control. I have pretty good insurance and when I last checked they weren't covered. That means paying for the IUD (a couple hundred dollars) + some drs appointments totally out of pocket (definitely a couple hundred more dollars) and probably going to a different doctor because the place I usually go might be too pricey if insurance isn't covering the visit.
posted by oneear at 9:31 PM on October 7, 2014


On the one hand, I get it, you don't want to accidentally give a pregnant woman thalidomide or accidentally cause her fetus to abort, that is tremendously expensive for your malpractice insurance. On the other hand, if your answer is, "I haven't had sex in literally 18 months AND I am on hormonal birth control," they will still make you pee in a cup before giving you an MRI to make sure you're not pregnant before they harmlessly scan you.

As I lawyer I understand the liability issue, but as a woman it makes me SUPER GRUMPY especially when it means your concussion visit to the ER lasts an extra two hours for the pregnancy test to come back before you can get the CAT scan that would be LITERALLY TOTALLY HARMLESS ANYWAY.


If it makes you feel any better - and golly, it won't - in Australia, where there is no comparable history of medical liability litigation, I had to pee in a cup to get my radioactive iodine, even though they had scans on hand that showed my IUD in situ, and the medical record that showed when it was placed, because of radiation safety laws.
posted by gingerest at 9:31 PM on October 7, 2014


Kathryn: Serious question, doesn't every doc ask every patient what medications they take?

This isn't part of the "what medications are you taking?" question -- plenty of contraception options aren't medical. This is part of a discussion that goes like this, in its most extended form:

When was your last menstrual period?
"About three weeks ago."
You don't know exactly? What are you and your partner using for birth control?
"Well, I had to stop taking the pill because after my father had a whole slew of pulmonary embolisms, we decided it wasn't worth the thrombosis risk. So right now we're using barrier methods, mostly."
What do you mean by mostly? Are you taking prenatal vitamins or a folic acid supplement?
"Well, mostly, I mean. Sometimes we use withdrawal, or we don't use anything. I'm 28, we've been talking for a while about maybe having kids soon, if I got pregnant it wouldn't be the worst thing in the world --"
You need to be scheduled for a pre-conception workup as soon as possible; that will be a long appointment, so make it on your way out at the front desk rather than through the online system. I'm going to write you a prescription for a prenatal folic acid supplement, as well.
"I already take folic acid as part of my women's multivitamin, and anyway, I'm here for a followup on the plantar warts I had cut out three days ago, any way we could take a look at those, since we're already eight minutes into a fifteen minute appointment time?"

It can feel sometimes like the medical community is way more concerned with my status as a potential pregnant uterus than they are with any other medical problem I may currently actually have.
posted by KathrynT at 9:37 PM on October 7, 2014 [23 favorites]


The exact cost seems to randomly (and infuriatingly) change but the last time I picked up my partner's birth control pills for her it was $120 after insurance.

Insurance may not cover [IUDs] even if it covers other birth control. I have pretty good insurance and when I last checked they weren't covered.

In the event y'all are in the US and this has been a thing in the last year-ish, complain loud and long to whoever's administering your insurance, because they aren't complying with the law. Or else the insurance is provided through a religious institution or certain businesses that want to pretend they're religious institutions when it suits them. Ahem.

The ACA is genuinely a major change for the better in this area, and it is a wonderful thing to be able to make decisions about what forms of contraceptives you want to use based on what would be best for you medically and fit best into your life, not just what's cheapest. (Of course that doesn't count things like wages lost from time at doctor appointments, or cost of transportation, or any other indirect expenditures, but at least you should not be charged at point of service anymore.)
posted by asperity at 9:54 PM on October 7, 2014 [2 favorites]


As a non-lady person I'm still a little confused why IUD's aren't in broader use.

As a lady-person who has considered getting an IUD, even with the costs and procedures involved: my body doesn't deal well with hormonal birth control, which rules out Mirena, and my comically heavy periods rule out Paragard.

And that's all of the IUDs on the market.

The second someone comes out with a non-hormonal IUD that doesn't increase bleeding, I'm in.
posted by evidenceofabsence at 10:03 PM on October 7, 2014


In the event y'all are in the US and this has been a thing in the last year-ish, complain loud and long to whoever's administering your insurance, because they aren't complying with the law.

My old health care would only cover generic versions with no additional co-pay, even if you were already using (and thus can't just switch) the name brand version. Before I left it, I got a very stern letter that they had been improperly covering the name brand versions with reduced copays, but that was going to stop as of August. I got charged a different amount every single time and to be honest, my time was worth more than phoning them to try to figure it out. (On the plus side, they started offering 3 months at one time after the ACA.)
posted by jetlagaddict at 10:05 PM on October 7, 2014


In the event y'all are in the US and this has been a thing in the last year-ish, complain loud and long to whoever's administering your insurance, because they aren't complying with the law.

As Planned Parenthood says:

Health plans are allowed to limit free coverage to some generic drugs and devices. All other birth control options will continue to be available to you with co-pays.

If the generic works for you, you are golden. If not, better have your wallet handy.
posted by Dip Flash at 10:26 PM on October 7, 2014


And if you think it's not enough fun and judgement being a straight, ladylike lady-bits person who needs birth control, try being a queer manly lady-bits person who needs hormonal intervention to make the awful pain and bleeding for most of the month STOP.

That being said, the progesterone-releasing IUD (I have a Mirena) must have been invented by Kwan Yin herself. Hardly ever have periods; when I do, it's a day or two of barely enough to notice. Also, not spending $30+/month on champagne-cork sized tampons.
posted by Dreidl at 10:48 PM on October 7, 2014 [6 favorites]


If the generic works for you, you are golden. If not, better have your wallet handy.

Ah, hadn't come across that yet myself. At least both available IUDs are covered.
posted by asperity at 11:39 PM on October 7, 2014


I would love to get an IUD; I work in a place where risk of sexual assault is elevated and am generally on antimalarial prophylaxis which makes birth control ineffective. The first time I tried to get an IUD inserted, the doctor was resistant to prescribing it because I was young and unmarried: this meant that I hadn't had kids so placement was supposed to be difficult, and I could potentially be having wild sex with all sorts of people, which could have increased my risk of infection as a result of IUDs (??). I argued a little, but then it came out that student health insurance didn't cover IUDs, so I decided to just cross my fingers and try avoiding sex as best as I could. I finally got a doctor to write me a referral to go see a different OBGYN so they can discuss whether or not they'll give me one, and insurance will cover it. I'm a little older now, and better at advocating for myself in a medical setting, and also have a few stories to prove exactly why I need one given where I work.
posted by ChuraChura at 4:50 AM on October 8, 2014 [1 favorite]


also have a few stories to prove exactly why I need one given where I work.

It is so angering that indeed there are doctors for whom this would be necessary (and even so might be insufficient) before they would provide basic medical care. The good thing is that there are good, non-judmental doctors as well, who would just move straight to discussing the best options without needing the justification stories. But just think how many women are dissuaded from even seeking care because they (largely correctly) assume they will face barriers and shaming.
posted by Dip Flash at 5:18 AM on October 8, 2014 [1 favorite]


As a non-lady person I'm still a little confused why IUD's aren't in broader use.

A lot of doctors will also steer you away from them because they simply haven't kept up with the literature and don't know how to insert them. If you're young and haven't had kids, you're more likely to be going to a general practice doctor or clinic doctor for your annual. The best advice I got when seeking out my second IUD was to find an OBGYN to do it, because they probably have the most practice. I called and specifically asked if they were IUD-friendly when making my first appointment for a well-woman exam. My first IUD was done by an extremely wonderful Planned Parenthood nurse practitioner who also had a ton of experience with them.
posted by almostmanda at 6:51 AM on October 8, 2014


I've had a catheter and an IUD. They went different places.

....I was talking to a guy and trying to pick a situation that may have happened to him. Call it a hunch, but i'm guessing he's never had anything inserted through his cervix, so....
posted by EmpressCallipygos at 8:20 AM on October 8, 2014


I have an IUD. It was 10 seconds of horrible, horrible pain during insertion for 12 years of not having to worry about birth control. I am totally happy with my decision.
posted by Librarypt at 8:27 AM on October 8, 2014 [3 favorites]


Just to clarify, that wasn't meant as a judgment on anyone who chooses not to get one, just that the pain wasn't an issue for me personally when considering an IUD.
posted by Librarypt at 8:55 AM on October 8, 2014


which could have increased my risk of infection as a result of IUDs (??)
posted by ChuraChura at 6:50 AM on October 8


This has been explained to me this way: the IUD has a bit that sort of dangles downwards, and STDs can "climb" it to get further into your body than they'd normally be able to. Somebody with a medical background could probably explain it better.
posted by joannemerriam at 10:49 AM on October 8, 2014


yeah, jaguar mentioned that in a comment earlier here
posted by poffin boffin at 11:48 AM on October 8, 2014 [1 favorite]


Thanks, KathrynT, I can see how that would be annoying.

Eyebrows: HAH! In Canada I had a CT scan, everything was fine and I wasn't allowed to leave the ER until they got the pregnancy test results. They asked if I could be pregnant, I said no, but they said they still have to do the test, so they did, but they did it after the CT scan, which was potentially urgent. Clearly they weren't actually worried I was pregnant, but they just needed to be able to say they'd done it.
posted by If only I had a penguin... at 11:58 AM on October 8, 2014


UGH. The casual judgment from doctors. This made me suddenly remember a conversation I had with my GP right before I started college, during a route check-up. We discussed the new HPV vaccine and my doc said she wanted it to be around for longer before she recommended it, and that it wasn't necessary... unless I planned to have a ton of sex right away with random guys, ha ha!

18-year-old-me was like haha! Okay, yeah, no worries, that's not my plan! I don't even have a boyfriend! Your judgment sounds good.

Modern-me is like... what the FUCK! How I wish I had said with a straight face: "Actually I'm planning on having, like, a LOT of sex with as many guys as possible. Right away. Is that a problem?"
posted by Solon and Thanks at 12:06 PM on October 8, 2014 [5 favorites]


Wow. Never have I been more happy that I've never had an experience anything like what's been described here. I've never had so much as a raised eyebrow when I've asked for regular birth control, an IUD, or a mid-year STD screening. And I'm an unmarried lady, now in my 30s, who's been doing this for 10 years or so. I do get an unnecessary annual pap smear and breast exam with my annual visit, but I don't I find it degrading or embarrassing or anything.

I tend to choose female doctors, so maybe that's a factor? Also, I work for a state agency, so I have a diamond-encrusted-platinum-level insurance plan, so I'm sure that makes a difference too. I got my IUD before Obamacare and didn't pay a copay, even for the pre-insertion office visit.

If anyone is still reading this and thinking about getting an IUD - it's awesome and liberating and I love not having to take a pill every day. Especially if you're not in a committed relationship. There's none of the weird "why am I taking this pill when I'm not even having sex" feelings. It's been a set-it and forget-it experience.

Off-topic, I've also never been fat-shamed by a health care worker. Or even had my weight mentioned in a doctor's visit, unless I brought it up first. Again, I think I must've won some sort of secret health care lottery.
posted by charlie mccarthy at 1:22 PM on October 8, 2014 [1 favorite]


I was floored at the price of my IUD. $325 that my insurance didn't cover. It was well worth every penny and I'd recommend it to anyone, but there's no way I would have been able to afford that at any point in my 20s.
posted by futureisunwritten at 1:38 PM on October 8, 2014


I tend to choose female doctors, so maybe that's a factor?

Eh, I don't think it necessarily matters what gender the doctor is. I've had a female gynecologist treat me so grotesquely badly and with such open contempt that I threw up in the bathroom immediately after the exam and had a panic attack on the train home.
posted by poffin boffin at 1:42 PM on October 8, 2014 [2 favorites]


What I want to know is why people don't know about Nexplanon, because it is magic.

What if an IUD
- was soft, flexible silicone
- took literally 30 seconds and zero pain to insert, while fully dressed
- went in your upper arm where you never noticed it
- lasted for three years
- was more effective than every other method, including sterilization, literally
- had a decent chance of decreasing your period or eliminating it altogether
- was extremely quickly reversible if you wanted to have kids later
?

MAGIC. But nobody knows about it!
posted by booksandlibretti at 1:43 PM on October 8, 2014 [1 favorite]


Except that IUDs deliver hormones locally or not at all, and subdermal contraceptive implants deliver hormones systemically. And implants are also treated with suspicion in the US because the first generation of implants had a high rate of contraceptive failure from incorrect insertion.
posted by gingerest at 1:52 PM on October 8, 2014 [2 favorites]


*holds up flag of support for Nexplanon*
posted by Catseye at 5:16 PM on October 8, 2014


i have multiple lady friends who had HORRIFIC experiences with the implant. like perpetual months long light bleeding, massive mood swings, and other stuff.

i also have a friend whose a total evangelist for it though, so it's obviously not universal. I just thought it was interesting that even as a guy i've heard several warnings and stories about it, whereas the same people had no real problem with the pill.
posted by emptythought at 5:41 PM on October 8, 2014


Except that IUDs deliver hormones locally or not at all, and subdermal contraceptive implants deliver hormones systemically. And implants are also treated with suspicion in the US because the first generation of implants had a high rate of contraceptive failure from incorrect insertion.

Yeah, I hate seeing people rule out Mirena because of the hormones. I was a sobbing emotional wreck when I was taking generic Ortho Tri-Cyclen pills. Mirena hasn't given me any of the same side effects.
posted by almostmanda at 6:56 AM on October 9, 2014


I was a sobbing emotional wreck

I read that as "I was a sobbing oatmeal wreck," and that's about how I felt on whatever hormonal BC pill I once took, so I like it.
posted by jaguar at 7:32 AM on October 9, 2014 [1 favorite]


An implant may be magic if you don't get horrible effects from the hormones. Considering the depression, moodiness, and inability to focus I get from BC pills (among other things), and the extreme vertigo with vomiting I got from the patch, there's no way I'm implanting anything with hormones under my skin.

Hence, I had to get over the squick and fear factor and get an IUD -- the Paraguard has no hormones. But, yep, it does increase bleeding and cramping something awful. There are just no good options. 11 years in, the Paraguard was a good choice, and I'll probably re-up next year when it's time to get it removed, but it's definitely a compromise.

And no, STDs won't climb up the string. Infection was a problem with one particular IUD which used a string that could wick bacteria into the uterus, but it was removed from the market in 1974. All IUDs since then use monofilament (like fishing line) which does not wick and does not cause infections.

And insertion, by the way, was bad only because of my own anxiety. The cramp with insertion was less than my normal cramps. But I think fear of the process is what keeps a lot of women from getting them, I know the idea of it scared me.
posted by antinomia at 8:52 AM on October 9, 2014


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