Endometriosis and Birth Control: My Journey to Reduced Symptoms

I began taking birth control pills when I was 21 and continued taking them until my early 30s. I had to stop taking them after a blood pressure crisis landed me in the emergency room. While the crisis had nothing to do with the birth control pills, my gynecologist took me off them as a precaution. It was only after I stopped taking them that I began experiencing symptoms of what I would later find out was endometriosis, a chronic condition that can cause painful periods.

My endometriosis diagnosis
When I was in my teens, I experienced cramps during menstruation, and my periods were longer than what most of my friends experienced. But to me, nothing really seemed abnormal. My periods would last exactly seven days and the cramps were never so bad that I had to miss school.

After I stopped taking birth control, however, things had changed: The cramps were much worse than I ever remembered when I was young, and my periods would range in length from five to 10 days, with my cycle varying quite a bit as well.

I began experiencing pain during sex, but it wasn’t until I began having extreme abdominal pain at random times that I sought out an answer. One doctor referred me to another doctor and then to another before my gastroenterologist suggested that it might be endometriosis. My gynecologist later confirmed this diagnosis through laparoscopic surgery.

I later saw an endometriosis specialist who told me that progesterone, a key ingredient in birth control pills, can limit the growth of endometriosis. He suggested taking a compounded progesterone pill that wasn’t a birth control pill. While it helped some, I still had cramps and bloating during my period.

Birth control pills, round 2: Searching for endometriosis relief
Because my blood pressure had not been an issue in several years, I asked if we could try putting me back on the same pill I’d had success with for so many years in my 20s: LoEstrin Fe. My doctor agreed that it was worth a try.

I took it for about six months, but my body’s response was not the same as it had been previously. I experienced severe cramps and bloating during my period, which are symptoms of endometriosis, according to the Office on Women’s Health. And, to make matters worse, the pill seemed to affect both my mood and sex drive, causing stress in my already-stressed marriage.

I returned to my specialist in tears. He put me back on progesterone at a higher dose and my symptoms decreased significantly. My sex drive also returned and overall life improved.

Looking back, I can’t recall if he ever suggested an intrauterine device (IUD). It’s possible that he did, and I resisted it because the idea scared me. My husband eventually got a vasectomy, so birth control wasn’t really an issue anymore.

Could an IUD be the answer to endometriosis woes?
Following my divorce in 2017, I began considering birth control again primarily because compounded progesterone wasn’t covered by my insurance and I couldn’t afford the expense.

When I visited my regular gynecologist, the nurse practitioner was surprised that despite the dosage of progesterone I’d been taking for several years, I still had full periods. She suggested that I consider an IUD. According to her, it would solve all my problems.

She told me that most women eventually stop having periods with a hormonal IUD, and the progesterone it releases would keep the endometriosis in check.

I’d just had my third endometriosis surgery less than a year prior to this discussion, and I wanted to avoid a fourth, if possible. It would also act as birth control, and given that I planned to start dating again, that would become a necessity.

I opted for the Mirena IUD on the suggestion of my gynecologist, and I was quite happy when my insurance fully covered the insertion and follow-up visits, making this a completely free birth control option that would also (hopefully) reduce my monthly medication costs and control the endometriosis.

Almost a year later, I still have periods. I’m guessing I am one of those that probably always will. However, my periods are now so light that I don’t need more than panty liners. For the first six months, I spotted almost continually. Now, I just have really long periods — about 10 days, typically.

On the upside, I have no cramps or other endometriosis symptoms. I’ve also not had any change to my mood or sex drive because of the IUD.

On my last visit to the endometriosis specialist, he was amazed at how well I was doing. The tightness and tenderness he usually encountered during my exams was completely gone. I would normally see him every six months, but I now only need to see him annually.

I really wish I’d gotten an IUD earlier. Had I opted for this option after my earliest surgeries I might have avoided the most recent one, and I know I would have saved money and experienced a lot less pain. If you’re struggling with endometriosis, I encourage you to speak with your doctor about birth control options like the IUD. While birth control affects everyone differently, it could be the solution you’ve been looking for.

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How Long Does Sperm Live Outside the Body?

Question:
How long does sperm live outside the body?
Answer:
A sperm’s life cycle outside the male body begins at the moment of ejaculation. Some die within minutes, and some can live anywhere up to seven days, under perfect conditions. But most live about two or three days inside the female reproductive system, according to USC Fertility.
Typically, one ejaculation contains up to 500 million sperm, according to the University of California, Santa Barbara (UCSB). You need just one sperm to make it to the right place — the correct fallopian tube — at the correct time — after ovulation — to create a new life.
This makes it seem like pregnancy could occur very easily. It often does, of course, but most sperm die before making it to their final destination, according to the American Pregnancy Association. Understanding how long sperm live — inside and outside the body — can help whether you are trying to get pregnant or trying to avoid getting pregnant.
The sperm’s journey to the egg
The goal of a sperm is to swim through a woman’s cervix and uterus to end in the fallopian tube in search of an egg. It isn’t as easy as it sounds. During this process, sperm cells face many obstacles, and with each obstacle, the sperm count goes down. Out of the half-million sperm that started out on the journey, relatively few actually reach the woman’s egg — if there even is one available at that time.
How long does sperm live if it’s outside the woman’s body?
When a sperm ends up outside of the woman’s body, it lives only a few minutes. Sperm needs moisture and warmth to live, so once exposed to air, they quickly die. As soon as semen dries, the sperm within it dies.
This might lead to the idea that “pulling out” before ejaculation can prevent a pregnancy, but that isn’t always the case. Pre-ejaculation fluids can contain sperm and can be left inside the vagina before you pull out, according to UCSB. Additionally, semen that is close to the vagina where there is warmth and moisture can live up to 20 minutes and can still make it inside. The pull-out method of birth control isn’t usually effective because it’s often used incorrectly.
Can sperm survive in a hot tub?
Because sperm need moisture and warmth to survive, it is possible for sperm to live when ejaculation occurs in a hot tub, but they only survive for a few seconds according to UCSB. The chances of becoming pregnant in this way are very slim. The ratio of water to sperm is quite high ,and the chances of a sperm making it through the water and into the vagina is low. Besides, any chemicals, soap, or suds in the water are likely to kill the sperm.
How long is there a risk of pregnancy when the man ejaculates in the woman’s vagina?
During vaginal intercourse, sperm is deposited in the acidic vagina according to the UCSB. This atmosphere kills the sperm that don’t make it to the cervix within hours. During ovulation, the pH of the reproductive tract becomes less acidic and sperm might live a little longer, giving them extra time to swim upward toward the cervix.
Sperm that make it to the cervix and uterus have a longer life. They can live there up to five days, according to the American Pregnancy Association, although most will die within one to two days. Here, cervical fluids work to propel the living sperm through the uterus and into a fallopian tube. Some experts believe that the cervical fluid acts as a filter, allowing the most motile sperm through while stopping less motile sperm.
Finally, some sperm make it to a fallopian tube. Although a few thousand might make the complete journey there, only a few will find an egg. The rest die during the search, according to UCSB. The average life of a sperm that makes it to the fallopian tube is three to four days, although some can live as long as a week. That means an egg making its way through the fallopian tube during that time could be fertilized, potentially leading to a pregnancy.
But what about the lifespan of an egg? If as perm does make it to the fallopian tube, it must fertilize the egg within 12-24 hours of the egg’s release from the ovary in order for pregnancy to occur, according to the American Pregnancy Association.
What to do if you believe you’re at risk of unwanted pregnancy
Think you may be at risk of unintended pregnancy? Emergency contraception is available. There are several options available, including over-the-counter pills, like Plan B, and even the copper IUD. No matter which option you choose, it should be taken as soon as possible after unprotected sex. For example, Plan B One-Step should be taken within 72 hours after sex. But the sooner you take it, the better it works.
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