The Progesterone Experiment

Part Two, and Final

I write about my difficulties with my reproductive organs as a way of contributing to the body of wisdom based on lived experience that so many of us draw from as we try to navigate our health, when the medical community fails us—despite often trying their hardest. There’s going to be some gnarly descriptions. If you’re bothered by this stuff, don’t read this one.

I lasted nearly six months with the Mirena nestled inside my uterus. I mean, I couldn’t walk more than three blocks without excruciating pain, I went on anti-depressants to balance out the negative mood effects and found that even those weren’t enough to compensate for the hormonal chaos, and the spotting—which is supposed to get better over time—increased, and increasingly became full-on bleeding. But I almost made it to the six month mark.

A few people who’d had similar issues with the Mirena said the lower-dose Skyla might be worth a shot. I’d given up on the first endocrinologist as she’d indicated she’d run out of options for me. The second endocrinologist said that we didn’t have the Skyla in the country but that it was the only thing she’d heard of—though its existence was news to her that day—that I hadn’t tried. She also said to keep taking the myo-inositol, which I do, when I remember. We’ll get to the concept of remembering shortly.

Since the Skyla wasn’t available in Serbia, I had three options; have it smuggled in and installed by a gynecologist who was comfortable installing a grey-market device, travel to a country in the EU where I don’t speak the language at all, or make the trek to the United States. A friend helped me schedule an appointment in New York State for mid-August, and verified that they would have the exact device I needed.

Customs, this time, was very simple. The officer asked where I’d been. I said “Greece, North Macedonia, Serbia, Germany, whatever country Amsterdam is in, and the UK.” He said “The Netherlands”. I said “huh?” And then he asked whether I was bringing anything back with me. I told him I lived in Serbia, he gave me that look that says this person does not fit the script, and told me to go ahead. At no point was I asked what the purpose of my visit was, so I was robbed of the opportunity to talk about the global state of what we call women’s health.

But fortunately, I have this blog.

At the clinic, the nurse told me they were going to use a tenaculum, and to take my pants off. When the doctor walked in I was still wearing pants. I told her I was debating leaving because of the tenaculum. Imagine something like a pair of scissors with teeth resembling a cat’s incisors, which grabs onto the cervix and holds it in place. She said “But you’ve had an IUD before…” and I informed her that mine had been inserted without the tenaculum and I considered the tool unnecessarily painful and superfluous. We debated, she seemed to feel like I had challenged her capacity as a medical professional, and responded by saying that she was perfectly capable of doing the insertion without essentially using a pair of metal teeth. So we did it without. At the end, when she was cutting the strings, she said “I’m going to leave them nice and long.”

I’d love to say there were no problems. I am, however, happy to say that the problems had nothing to do with skipping the tenaculum. Thanks to NY State’s decriminalization of marijuana, I was stoned out of my mind on Northern Lights for both the procedure and the following few days.

I started having nightmares about the strings. One that I remember vividly involved squatting down to tie my shoes and accidentally tying the strings to my shoelaces, then standing up and ripping the device out. By the time I returned to Serbia I was in immense pain. We were, once again, going the wrong direction. I told the local clinic I would see whatever gynecologist had the soonest opening. I ended up with the laparoscopy guy.

As I was telling him my story I saw that expression. The one medical professionals make when a patient is using too many big and accurate words. When the patient seems like maybe they think they know more than the doctor. I’ve learned how to navigate this, and while my particular script may not apply directly to readers, I’ll leave it here in case some useful adaptation can be made:

“I should tell you, I’m essentially a sex educator so I’m familiar with a lot of the terminology, but I also know that you’re the expert here and respect your larger body of knowledge.”

The laparoscopy guy found an infected IUD (during the visual examination) and a few endometrial lesions on my right ovary (during the ultrasound). He asked if I knew I had endometriosis. I said “No, but it doesn’t surprise me given how often PCOS and Endo co-occur.” He told me I really know my stuff.

I have to know my stuff. It’s my body. It’s “women’s health”. Many medical professionals have tried, and have done their best, but it’s a 25 year and counting problem and the only hope I have of solving it is to Know. My. Stuff.

He had me cough as he was tugging out the device, which made removal hurt even less. And he asked me whether I wanted it cleaned or as-is when I asked whether I could keep it.

The doc suggested yet another form of oral contraceptive, and I—with the hopefulness of hormone induced stupidity—agreed. It was an absolute disaster. My brain was so broken I couldn’t remember the lyrics to songs I’ve been hearing since before conscious memory. My brain—the organ I use to support myself financially, and the thing my mother always emphasized was so much more important than the looks I leveraged in my 20s and early 30s. I found myself having to look up basic facts, facts that are considered common knowledge, in the course of writing my Slate columns.

I mean, maybe it’s not so bad to fact-check thoroughly, but this was extreme.

Patrick, one part of the “keep Jessica duct-taped together until the hormones settle down again” team, ended up describing the situation to his friends thusly; “You know how your wives get PMS? Imagine this times five for an entire month and counting”.

A quorum of friends all stated, individually, that they would really appreciate it if I could be finished with progesterone experiments. My regular gynecologist indicated that it would be wise to avoid progesterone in the future.

I’m only just now, on 9 October, able to write more than a couple of paragraphs. I feel social pressure to say “IUDs and HBC work really well for lots of women” but I feel internal pressure to say “So many of us are failed by what ‘works best for most people’, and we need better science.” My period is so late it should have been over by now, but at least I can think again. I can remember things. I can complain coherently.

Somewhere in my apartment is a blood-encrusted Skyla.