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Paranoia affecting my sex life

Hi ladies (and gents if any here),

I'm a 27 year old nulliparous woman with Factor V Leiden and a history of one large blood clot in my left thigh (that to my knowledge is still there but "scarred over", per my hematologist).

Because of this, I can't take estrogen and opted to get a Paragard IUD inserted last August. I had an ultrasound in October and it was firmly in place.

However, the knowledge that about 6-8 in 1000 women per year may become pregnant with the copper IUD has made me too scared to have sex. Prior to this we were using condoms alone, but I wanted something more robust in terms of protection. I also wanted to ditch the condoms because they rub me raw and dry me out! Husband also has difficulty reaching orgasm while wearing one. Basically they made sex feel like a chore rather than, well, sex. Since getting the IUD, until my anxiety took over, our sex life was getting back on track.

I'm quite conscious of the back and forth surrounding abortion in the States. I never want my own children and would be devastated if I ever became pregnant. Partially because I'd have to take heparin for months, be closely monitored regularly then give birth while on blood thinners. Partially because I just don't want to be a mother. In short, can't afford it and feel it's too dangerous. I would get an abortion right away, but as I said... I feel like one day I'll wake up and abortion has been made illegal. I think I would actually kill myself if I found myself in that specific situation.

By making this post, I hope maybe I can get some reassurance that this IUD will do a good job of protecting me. It's done well so far but every month as my period due date nears, I get so anxious. I actually haven't had sex in over a month because I'm so scared. Please shine the light of wisdom upon this scaredy cat!


( 6 comments — Leave a comment )
Feb. 15th, 2017 10:22 pm (UTC)
First off, *sends electronic hugs* for use or re-gifting. Because yeah, I hear all that. Very much.

So, things that might be reassuring... Which aren't necessarily that reassuring, but kind of...

1: While less than 1 in 100 people per year would statistically get pregnant (according to Paragard.com; 6-8 out of a thousand, yes, from http://paragard.com/pdf/PARAGARD-PI.pdf), if one got pregnant with an IUD, the odds are on an ectopic pregnancy, which -- while being a major health risk -- is one that is generally understood to be Non-Viable and Life-Threatening. I.e., it has to go, and if you have non-religious hospitals around, the odds are very good that would get dealt with.

1a: Talk to your local hospitals and make sure that they handle ectopic pregnancies with the necessary termination of the pregnancy -- verifying this may help.

1b: You may feel more empowered in general if you can call a representative and tell them exactly this. Or write to them about how concerned you are, and how much you're worried about it. (Phone calls to my Congresscritter and Senators help a little. I need to get the Governor's phone number and start giving him an earful too, though...)

2: http://paragard.com/pdf/PARAGARD-PI.pdf notes that it should be removed if there's a pregnancy, and that removing it can cause miscarriage. This is... not the best of reassurances, but it is kind of a second chance that I was actually just thinking of earlier. For, well, reasons. *sigh*

There are other things you can do, though! Just because you have an IUD doesn't mean you have to rely ONLY on the IUD! http://www.scarleteen.com/article/sexual_health/the_buddy_system_effectiveness_rates_for_backing_up_your_birth_control_with_a_ has an awesome Worked Out The Math section, and there are some non-hormonal methods that you can use. In particular:

a: a Cervical cap/cervical barrier. I think this includes diaphragms? Typical Use effectiveness becomes 99.87%.
b: Contraceptive sponges. If these don't bug you, and the cost per sponge is okay, you can insert one of these as well. This raises Typical Use effectiveness to 99.87% as well.
c: Withdrawal! While withdrawal gets a pretty bad rap, even by itself it's about 70% effective (typical use, and I'm rounding) and using nothing-at-all is like 85% chance of pregnancy. So if your partner is willing to try for this, Typical Use with an IUD is 99.78%.
d: Spermicidal foams/films/gels. Again, if these don't bug you, you can use them along with the IUD. 99.77% effective with typical use

There's also Fertility Awareness Method. This isn't listed as a "buddy" for IUDs at Scarleteen there (probabaly because they're not breaking out hormonal ones vs. copper ones), but it's something you can do with a Paragard. The full version has charting temperatures before you get out of bed and checking cervical mucous and stuff. But even my sloppy "notice if I'm goopy when I go to the bathroom" observations have often been more accurate than my phone app. (I get my period about 2 weeks after I notice serious goopiness, sometimes including -- sorry, TMI -- goopy "strings" dripping if I'm in the bathroom for a while. Ugh, but very distinct!)

So if you can figure out your ovulation signs and are reasonably regular, then you can try to avoid ejaculation-in-vagina sex, or double up on other contraceptive methods, for 3-7 days (depending on your sense of comfort) before probable ovulation, and about 2 days after (to allow for a second ovulation).

As Withdrawal and Spermicide alone are both below 75% effective with typical use, and FAM is listed as 76% effective, pairing FAM and a copper IUD would probably give typical use effectiveness of slightly greater than 99.78%.

I hope that these are of use to you! *offers more electronic hugs*
Feb. 15th, 2017 10:52 pm (UTC)
Firstly, thank you so much for your kindhearted replies. I'm used to posting on Reddit where the general consensus to people who ask questions is "you're an idiot, how dare you ask questions" :P

Secondly, I am considering adding FAM into the mix. I get quite noticeable egg white mucus, especially with this IUD in. It's gone crazy! My only worry is, if I have sex one day then the next I discover egg white, is that considered having sex within the fertile period? I like to think my cycles are regular, but sometimes they can vary by as much as 7 days in length, so I wouldn't be able to predict in advance when I'm gonna become a chicken.

Thirdly, an ectopic pregnancy would actually work out for me in a weird way. When it gets too far or the drug they use to kill it dead doesn't work, they remove the tube. I really want my tubes removed anyway, so here's hoping if I ever do get pregnant, it's ectopic and they take my goddamn stupid tubes out.

(I'm gonna stop numbering my paragraphs now!) I'm also comforted by the fact having the IUD out during a regular pregnancy can cause miscarriage. I feel really weird for saying I want a miscarriage, given how a lot of women would be devastated, but I just can't reconcile in my mind being a parent and don't want to play games with my blood issue. I also don't think the fetus would be too fussed if it fell out.

Again, thank you for your kindness and wealth of information. I'm gonna discuss some stuff with hubs tonight because I'm sure he has blue balls.
Feb. 16th, 2017 05:55 am (UTC)
Feh, Reddit. Here is for questions, not mockery. *nods firmly*


Yeah, with FAM, if you had the mucous the day after sex, that would be considered "in the fertile zone."

On the other hand, most people only ovulate once in a month, and if they do release a couple eggs, it's very close together. So if you wait 2 days after egg-whites, any eggs should be quite dead -- they're only viable for about 24 hours each. This does mean you'd want to engage in non-penetrtive sex for the first half of the month (69, manual, etc.) or sex with some other form of backup contraception, but a few days after the egg-whites? You could go to town, as the saying goes, and the odds would be in your favor that there wouldn't be any egg around to go "hello sailor" to any sperm that made it past the copper ions destroying their wiggle-ability. O;>

I mean, nothing in biology is 100% (...except perhaps that statement...), but you can probably stack the deck pretty well and play the odds.

Hope the discussion goes well! *grin*
Feb. 16th, 2017 11:18 am (UTC)

If it helps quell any anxiety, I've had my paragard since April 2014 and all the sex I've had has been unprotected and (tmi) for the most part ejaculation has happened inside me, including when I've been ovulating. IUDs are supposedly even more effective than a tubal ligation and copper IUDs can be uses as an emergency contraceptive. Copper is toxic to sperm so it's highly unlikely you'd get pregnant.

Feb. 17th, 2017 04:49 pm (UTC)
all of this. Had this IUD inserted in early 2014, have my partner mostly cum in me without a back-up method (a lot), even during ovulation. I've never even had a pregnancy scare.
Feb. 16th, 2017 05:38 pm (UTC)
As un_fantasma said, copper IUDs are about as effective as tubal ligation, so you've effectively got the best reversible BC you can have.

So, even if you did get your tubes tied, given that the effectiveness of that is similar to what you already have now, wouldn't you still be anxious then? If you wouldn't be, then you should be anxious now. As long as you check your strings monthly, go to your annual check ups and are getting your periods normally, you are fine and protected. At least with Paragard you still get periods so you'd know if you were pregnant pretty early on anyway since your period would be late.

For tracking cycle purposes, I recommend the app Clue which shows you an estimated fertile window. The more information you put into it the better it gets. Please note though that for FAM, cervical mucous, position and most importantly basal body temperature used together are the most accurate indicators of your fertile window.

The bottomline is, you're right, with Paragard 6-8 people out of 1000 get pregnant a year. But with tubal ligation, 5-13 out of 1000 get pregnant in a year! The higher number in that range with tubal ligations is after 5 years because there's a risk of the tubes growing back together. But Paragard stays the same effectiveness for its entire life.

So you see, the difference between the two is so small it basically means you've got your tubes tied with Paragard in place, and over a period of 5-10 years, Paragard can be *even more effective.*

Edited at 2017-02-16 05:39 pm (UTC)
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