I started seeing a new GYN in Dec 2014. She is AWESOME. I'm very comfortable with her. One of the things I wanted to discuss with her during my appointment (which was my annual check-up) was birth control options to address the heavy and painful periods I deal with. We did a lot of talking about the options, and after doing lots of research (from credible sources) and reading the literature she provided me with, I decided that the best birth control method for me -- one that would help with my dysmenorrhea and consequent anemia; wasn't super-costly like my previous method, the pill, had been for me; and didn't necessarily have to have a high rate of efficiency at preventing pregnancy since I'm not and don't plan on becoming sexually active any time soon (although the very high rate is still nice in the unlikely event that I do!) -- would be an IUD, namely, Mirena. It was also appealing because since I already am on several prescription medications for a variety of medical problems, I wouldn't have to worry about taking yet another pill or if my current medications would affect the efficiency of my birth control (since I have to make sure my medications don't interfere with one another each time my prescriptions/dosages change).
I personally feel that I've got a pretty good grasp on how Mirena works and its side effects. I'd been told when I called to make an appointment for insertion to take ibuprofen before the procedure and how much I should take to help with cramping. I've heard "horror stories" about the cramps that say the cramping that insertion can cause is comparable to the pain associated with labor, and how the equivalent-to-labor pain can last for weeks, but I take those stories with a grain of salt and keep in mind everyone is different, especially when it comes to bodies and pain thresholds. Also, I know that my periods could be heavier, more painful, etc. for a few months or so after insertion as my body adjusts. All this being said, it isn't actually the insertion-associated cramps and the aftermath that worries me. I've decided that Mirena is worth a try at helping with my periods. It's the insertion itself that has me worried. And that would be because of my cervix. *sigh*
As I've mentioned on my previous original post (the archived one, not the updated one on here), I've dealt with vaginismus, which was worsened by a history of sexual abuse, since my preteens. For reasons of simple curiosity about what my own internal anatomy/cervix looks like, I purchased a medical-grade speculum to do some looking with. The speculum is a Pederson model in size small, and even on my 1st attempt at inserting, I found it was super-easy to insert and that my vaginismus didn't even really interfere with it. I was really happy! Before I got out my mirror and light source, though, I realized I hadn't even felt my cervix. So one day I sent a (cleaned, lubricated) finger on a...search mission. What I found out about my cervix is what concerns me about having my Mirena placed.
Firstly, I happen to have a very high cervix. I've checked during several points in my menstrual cycle and found that even during times when the cervix is said to be lower in position, it's still pretty high-up. Also -- and I don't know if this is even something I should be worrying about since I don't know if it's common, not frequently heard of, etc. -- my cervix seems to be off to the side. Like, waaay over. (warning: this next part is graphic and contains way tmi!) When I feel with my index finger (the finger I always use to feel for my cervix), I find that I can insert my entire finger, almost to the point where it feels like I'm going past the knuckle where my finger and hand join, before I reach the end of my vaginal cavity. I've got pretty long fingers, which is what has me believing my cervix is very high. When I reach the end of my vaginal cavity, though, I don't feel anything aside from the normal foldy tissue constituting the "end" of the cavity. I decided when I first tried feeling my cervix to feel around that area since I know the vagina actually extends a little bit past the cervix. Long story short, after lots of feeling around, I finally found my cervix -- to reach it, though, I have to reach my finger to the extreme left (extreme left meaning that even with lots of caution and gentleness, it hurts my hand/knuckle to get my finger to stretch far enough.) Even then, I can't feel the entirety of my cervix because it's impossible for my finger to contort itself to feel for it.
After I felt my cervix, I then moved on to inserting the speculum and looking. Like I'd feared, my cervix wasn't in the field of view. I tried a number of times over about 4 months to see it, and while I'm pretty sure that it's made difficult by the high cervix/small speculum combination, I found out not that long ago that it apparently isn't impossible because when I was just about to give up, it moved itself into view. So, since it isn't impossible but still difficult, I think my small Pederson speculum may be too small (i.e., too short) to help me be able to visualize my cervix with ease. My GYN showed me at the end of my December appointment the variety of specula she has, and she even said that I could bring my speculum in (I know how to clean and care for it, by the way!
), so my concern as far as the speculum is concerned is that even if it's small enough in that it's narrow enough to be inserted without triggering my vaginismus, it may not be long enough to make my cervix accessible for the procedure. So basically that would mean in order for the speculum to be long enough to make my cervix accessible, it may also be wide enough to trigger my vaginismus since an increased blade length would also mean an increased blade width. (ooh, and also, I didn't ask my GYN this during my last appointment, but I'm going to ask her if I can insert the speculum myself before the Mirena insertion -- I don't see why I couldn't, since like I said she's pretty awesome and sensitive to patients' needs.)I feel like I'm rambling on here, so: I understand that I may be in for some cramps, but I'm prepared for that and have my ibuprofen ready to go (I plan on taking it about 30 min before my appointment). My cervix, on the other hand...not only am I scared it won't be accessible for the procedure, I'm also scared about the pain my cervix may be subjected to since, like I said, it feels like it's way off to the side. Having its os opened with a separate instrument is probably going to just exacerbate that possible pain. I'm not even sure that all this speculum talk I'm doing makes any sense! Like I said, I probably should've thought about this before scheduling for a Mirena insertion, and honestly I completely forgot to bring it up with my GYN during my appt. because we discussed a lot of things (and I also wasn't fully aware of my cervical position yet), so umm...help please?
(for what it's worth I've heard a local anesthetic can be administered to the cervix before the insertion? and also my GYN said I could have the procedure done under sedation, but I want to avoid having the Mirena inserted under sedation as much as I can because like I said I have a sexual abuse history)
