See Spot. See Spot Stain.
February 1, 2010 6:11 PM   Subscribe

I had a lady problem. You gave me a lady solution. The solution stopped working. Now I need more help from the best not-a-doctor-not-my-doctor around. Graphic details inside.

Thank you so much for encouraging me to get the NuvaRing. It is a miracle. I have used it to basically skip every period since August. However, I am experiencing near-constant spotting. On a friend's suggestion, I tried having a "period" (which sucked) a few weeks ago, after which I had no spotting... until now. It's back.

The thing is, for now, I'm kind of OK with it. It's annoying and inconvenient, but it's so much better than having my period that I have no words for how amazing it is. However, this can't possibly work as a long-term thing. I mean, one of these days, I might not be single any more. And, frankly, it's gross, and that gets old.

So now, I don't know what to do. The NuvaRing is so perfect in every other way. It's not a pill. It's a low dose, so my general anxiety about messing with my body is minimized. I basically never think about it until I look at my planner and realize it's time to get a new one.

I guess my questions are:

1. Is this it? Does this mean the NuvaRing will always cause spotting for me? Is there anything I can do or change to make it go away?

2. If not the NuvaRing, then what do I do? For now, I'd rather deal with this than take a pill every day. IUDs terrify me. They sound incredibly painful and apparently they sometimes poke men in the penis?! I am at a loss.

Thank you so much, MeFi. You've already improved my life immeasurably. I appreciate your time & thought.
posted by anonymous to Health & Fitness (22 answers total) 1 user marked this as a favorite
In the past question, you said you were afraid of the pill because of its artificiality, etcetera. But the nuvaring has the exact same kind of hormones and is linked to the same side effects. Why not just try a different sort of hormonal contraceptive? I'm not a huge fan of the pill for many reasons, but seriously, it's the exact same kind of hormones that are in the nuvaring. And, if you've never been on the pill, you might be surprised by how really not grossly inconvenient taking a pill every day is. I was worried about that too back when I was on the nuvaring, but in five years on the pill I only missed a dose once. Get a watch with an alarm on it; solves the problem completely. Also, with combination pills you don't have to take them precisely at the same time (actually, the ladies over at vaginapagina say there's a twelve hour window where you're okay).

Seriously, if you want to get rid of the periods, hormonal methods--be they IUD or the ring or the pill--are the way to do it. Just because one hormonal method causes spotting doesn't mean another will (though Mirena seems to be linked with that, at first, more than other methods, but your experience may vary).
posted by PhoBWanKenobi at 6:24 PM on February 1, 2010

IUDs are not that bad. It's 10 seconds of pain for 5-12 years of worry-free birth control. Also, they are the cheapest form of birth control you can get.

They do sometimes poke men in the penis, but when this happens it's usually only in the first few weeks before the strings have had time to soften and curl around the cervix. It's never happened to me.
posted by Lobster Garden at 6:24 PM on February 1, 2010

I second the IUD. My mirena has been the 2nd best thing I ever did for myself. (first was going to therapy)
posted by saveyoursanity at 6:33 PM on February 1, 2010 [1 favorite]

IUDs may poke men in the penis but it doesn't hurt, or actually poke, so much as get hit by the penis. This does NOT hurt the man in any way.

You can get a local (anesthetic) for insertion and, according to my GF, will have a week or so of spotting.

But IUDs do NOT stop periods if that is your goal, they just stop conception.
posted by Max Power at 6:39 PM on February 1, 2010

This is only a personal anecdote; I know nothing AT ALL about medicine.

I used NuvaRing for a year and a half, occasionally skipping periods. I was never able to skip more than one without the incessant spotting and some other (annoying but not-dangerous) side effects. I don't have stats, but I read that most women find it easier to totally suppress periods with a hormonal IUD than with the pill or NuvaRing; I think Mirena actually promotes this as part of their literature. That's in the long run, though; you're supposed to expect spotting for 3-6 months (which I promise you will feel like forever) and then it settles down for the next 1-4 years.

With that in mind, I switched to the Mirena. Before getting it, I was completely terrified by stories I'd heard, but insertion was a non-issue; I just took a cab home instead of waiting around for the bus in moderate discomfort.
posted by tantivy at 6:40 PM on February 1, 2010

Max Power, because hormonal IUDs release a constant stream of hormones, they will often lighten or stop periods. It's no guarantee, of course, but it's the same concept as when women take their pills / NuvaRing without taking breaks.
posted by tantivy at 6:41 PM on February 1, 2010

Have you tried having a period now that you're on NuvaRung yet at all? One of the reasons women like hormonal birth control is that it tends to make periods lighter, shorter, and/or just more predictable. I like to skip periods, too (I'm on the pill), but find that if I skip more than one in a row, I get spotting that won't quit. The only way I can stop it is to go off the pill for a week, deal with having a period, and then go back to taking the pill.

If you've had more than 28 straight days of hormones, taking the ring out for a week now or in the near future shouldn't affect effectiveness.
posted by oinopaponton at 6:50 PM on February 1, 2010

(that should say: taking the ring out for a week now or in the near future and then replacing it with a new one shouldn't affect effectiveness. Ew.)
posted by oinopaponton at 6:54 PM on February 1, 2010

Just a data point - I have used the Nuvaring for 3 years, often (but not always) skipping periods, and I have only had spotting if I left it in for 4+ weeks (which you aren't supposed to do anyway). I'd say if you haven't been on it for very long, give it a few more months. Also, be diligent about your timing - if you are going to skip a period, switch the ring out every 3 weeks.
posted by tryniti at 7:02 PM on February 1, 2010

IUDs sound scary to me too. If say you don't mind the spotting, what if you tried sticking with the Nuva for a few months where you DON'T try to skip the period and just do the off-week as planned. You might find that your period isn't as bad as it was before, and it's only for a specified, limited time, not day after day.

Or you can look into getting a really low-dose daily pill. I have my pills next to my toothbrush so I see them at the same time every day. It's pretty hard to forget them that way. I also have a few spares in my purse for emergencies.

One time I had a really long period because I messed up the pills for some dumb reason I can't remember right now, but anyway, what made it go away was that I stopped taking the pills until it stopped. Have you tried taking it out and leaving it out till it stops, then starting again? I'm not sure if that's what you meant by your friend's suggestion.
posted by amethysts at 7:02 PM on February 1, 2010

My SO used to have your original problem. She started taking Ortho Tri-cyclen lo about 8 years ago and no longer has crappy periods. Sure, it's still a little uncomfortable, but not at all incapacitating like it used to be.

Given the symptoms you posted originally, I don't think an IUD is the best option. You need hormonal birth control. I think there is one IUD now that also slowly releases hormones, so that might be an option.

You might try the patch, if you really, really don't want to take a pill every day.

Your gynecologist could probably shed more light on where you go from here. They'll be able to discuss the risks and benefits of the various forms of hormonal contraception that you require.

I think you're overthinking this stuff. Millions of women take hormonal contraceptives, and aside from a slightly elevated risk of heart attack among women over 30 who also smoke, the risk is utterly minimal. Most anything you'd be prescribed today would be of the low dose variety.
posted by wierdo at 7:04 PM on February 1, 2010 [1 favorite]

You said in your last question that you've had some trouble talking with doctors about this, but if you're going to think about an IUD you need to have a long talk with a doctor about it. My non-hormonal IUD gave me absolutely terrible cramps that took about 2 years to taper off. Over the years I've figured out my experiences are not normal, so I'm not trying to make you categorically rule anything out. You just need to be really up front with a good doctor about your concerns. You'll want to look into the hormonal one (Mirena) as that should eventually stop your periods; the Paragard won't stop your period and might create some really uncomfortable situations.
posted by lilac girl at 7:05 PM on February 1, 2010

Response by poster: My understanding is the spotting can happen because NuvaRing uses a lower dosage of hormones (since it's directly up in there). Sometimes going on the pill is more effective.
posted by Anonymous at 7:20 PM on February 1, 2010

Spotting generally goes away over time as your body adjusts. I have spent years period-free with NuvaRing. My boyfriend says that though he occasionally felt the ring, it never hurt or even bothered him. It sounds like you've found something that works for you, I'd just give it time to kick in.
posted by BusyBusyBusy at 7:26 PM on February 1, 2010

An IUD is nothing to be terrified of. Really. It's something to be loved and cherished. At least, that's my experience. I love my Mirena so much... I can't believe I dealt with that pill for so long (and my pill experience wasn't even that bad!).

Bad points:
* One uncomfortable day where it's inserted. For me, it was like a really bad PMS cramp. I took some Advil and slept it off. And no, I've never had kids.
* Strings. They do exist, and they might poke your man. But it's like being poked by a small piece of fishing line, at worst. The strings soften over time, and a competent obgyn will trim then so that your partner shouldn't ever feel them. Seriously. I've been told its a non-issue.
* Periods, if they do occur, might be a little irregular and hard to time.

Good points:
* Lasts 5 years!!! 5 years! You can have it taken out at any time, as well.
* Cheaper then BCP (after the initial investment) over those 5 years.
* A very good chance that your period will stop all together! And if it doesn't stop, they'll at least be really, really light.
* 20 times more effective at preventing pregnancy than the BCP.
* You will never know it's there.
* No pill to remember, no ring or cup to deal with, no nothing. No shots! Get it in once, and forget about it for *5* years!
* Because all the hormone is localized right where it needs to be, it only 1/7 th the dosage of a mini-pill.

No, I don't work for Mirena. I just really love mine. It's the best thing I've done for myself, and I never would have even known about it if it weren't for other health issues that required me to be on as low a hormonal dose as possible. (I refused to only use barrier methods of BC. The Mirena was the compromise between all my doctors.)

Seriously -- consider it. Everybody is different, but don't discount it just because it sounds scary. Its really not. And I'm as big a wuss as anyone.
posted by cgg at 7:49 PM on February 1, 2010 [3 favorites]

I completely, completely, completely agree with cgg.

I, too, was on the Nuvaring. I had them for about 18 months, and the spotting never went away. It was infuriating, and it was really a pain for keeping my clothes stain-free and not being awkward for sex. Lots of oh, that blood is nothing to worry about... really..... awkward.

I am also a wimp. I have cried after stubbing my toe. Getting the Mirena was SO WORTH IT. It hurt enough to make me gasp for a minute, like stubbing your toe would. I cramped a bit that day, played soccer in the afternoon, and since then have been cramp and period free. This is only really the case apparently for the hormonal version, not the copper one - your periods are often heavier on that.

It is so, so, so great.
- no issues with my partner
- no pain since the initial 'ouch' of insertion
- effectiveness
- easy - I don't have to do ANYTHING for 4.5 years still.
- cost - it cost me $50, the insurance covered the rest. Much better deal than paying for tampons and bc pills.

I didn't have a local anesthesia, but it's an option.
posted by foodmapper at 8:21 PM on February 1, 2010 [1 favorite]

I was on the NuvaRing for about five years, and I found that if I skipped more that one period at a time I'd start spotting (and would keep spotting until I gave in and had a period). And I hate having my period.

So I got the Mirena, and it's SO AWESOME. Insertion was kind of painful, like the worst cramp I've ever had, but really - I can deal with a little bit of pain if I know it's for a cause and isn't doing me any damage. I then had my period for basically a month (aaargh), and then, none! No side-effects! No spotting! No periods!

At least think about it. There are tons of posts on here about the Mirena in particular, so if I were you I'd at least read about it.
posted by you're a kitty! at 8:28 PM on February 1, 2010

Oops, meant to say: I suggest this thread in particular, and I wrote about my own experience there too.
posted by you're a kitty! at 8:35 PM on February 1, 2010

Is there a reason you can't go back and see the doctor who prescribed the NuvaRing for you? That doctor ought to be able to advise about the spotting, strategies for avoiding it, and alternative forms of birth control.
posted by zachlipton at 9:10 PM on February 1, 2010

Confirmed: iud string poke can occur. Disagreement: it did hurt. Eventual solution: vasectomy.
posted by eccnineten at 11:20 PM on February 1, 2010 [1 favorite]

Stop spot?
posted by flabdablet at 12:09 AM on February 2, 2010

I'm not sure the IUD would help with your pain problems at all-- in fact it might be just the opposite.

Did oyu ever find a non-asshole doctor? Because I still think reading your original question that you're probably experiencing endometriosis or ovarian cyst pain, and an IUD would probably be contraindicated there. You really need to talk to a medical professional about that.

In regards to the pain, I suggested in my last post that you consider seeing an acupunturist. I am reiterating that here. Even if you are a skeptic (which I am, generally) a couple of visits can't hurt.
posted by miss tea at 3:33 AM on February 2, 2010 [1 favorite]

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