By Sydney Schwichtenberg
In the operating room inside Goddard Health Center, then-freshman Brynlee Handy laid down on the soft leather cushion of the examination table and stared at the fluorescent lights above her head. Around her, a gloved doctor prepared Mirena, a popular form of birth control known for its longevity, to be inserted.
Despite her doctor’s insistence the procedure would be only uncomfortable, Handy worried about the pain.
“My mom told me it was worse than childbirth,” Handy, now a professional writing senior, said.
Offered no pain medication other than the suggestion of taking Aleve or Advil an hour before the procedure, Handy said she experienced the worst pain in her life as the IUD was placed in her uterus.
“The after-pain was almost as bad (as insertion) because it was like rolling waves of equal parts pain and nausea for three or four days,” Handy said. “(As if) someone was constantly punching you right in your uterus.”
Mirena, which is a soft, flexible piece of T-shaped plastic, contains the hormone levonorgestrel. The birth control thickens cervical mucus to prevent sperm from entering the uterus, and its popularity is due to its promised five years of protection against pregnancies.
“Long-acting reversible contraception methods like IUDs and Nexplanon are popular and highly recommended because they have zero percent user error,” Katie Qualls, a health educator at Goddard, said over email.
Although Mirena has done the job of preventing pregnancy, Handy’s experience with the IUD goes beyond just physical pain of insertion. Since the procedure, it’s her mental health she worries about most.
“They gave me a little pamphlet and said here’s what can happen and here’s this tiny, size eight font of stuff that will happen,” Handy said. “I obviously threw that away.”
Inside OU Health Services’s brochure for ‘Types of Contraception,’ there are no listed side-effects outlining possible mental health issues.
“Discomfort during insertion, can become dislodged in rare cases,” the brochure states.
Handy had no idea how her mental health would be negatively affected in the coming months, as medical professionals from Goddard failed to tell her about possible side-effects.
“I feel like ever since getting the IUD in, it’s like the highest highs and the lowest lows,” Handy said.
Some patients feel may need over-the-counter painkillers or heating pads for cramps after getting the IUD, according to the OU Heath Center brochure. There is no mention of how mental health can be affected.
“You may experience cramping during and after the insertion,” the brochure states.
This wasn’t the case for Handy. Handy laid down on the operation table for several minutes, hoping the pain would pass. After a half-hour, with pain still rippling through her, Handy grabbed a one-day doctor’s note and spent the upcoming week curled in her bed. It’s been years since Handy received the implant, she said she still feels the “knife-pain” in her uterus at spontaneous times throughout everyday life.
“If your symptoms do not pass within 30 minutes after placement, Mirena may not have been placed correctly,” Mirena’s website states. “As a follow-up, you should visit your healthcare provider once in the first four to six weeks after Mirena is placed to make sure it is in the right position. After that, Mirena can be checked once a year as part of your routine exam.”
Goddard made no mention of a follow-up examination, said Handy.
“We encourage patients to follow up with their provider if they have questions or concerns,” Qualls said.
Handy isn’t the only one who has experienced worsening mental health since being prescribed birth control.
Heather Ortega*, an OU athlete, said her life has changed since receiving her Nexplanon implant the summer before she left for college.
The Nexplanon is a tiny birth control implant that provides three years of pregnancy prevention. The estrogen-free plastic rod is inserted in the patient’s arm. Like Mirena, there is no mention of mental health side effects listed on the product’s website.
Ortega had no idea it could cause anxiety or depression, but according to hundreds of threads from online forums, countless women share her same experience.
Ortega researched the side-effects, like sudden anxiety and depression appearing out of nowhere, and believed those were simply extreme cases. She said she never thought they could happen to her.
“(My doctor from home told me) some things that could result in this is weight gain,” Ortega said. “You’ll sweat more, but she said ‘we don’t really see other side effects than that.’”
Over the course of two years, Ortega’s mental health slowly depleted. Ortega believes her negative experiences are a direct result of the implant.
Ortega said her friendships and romantic relationships have been affected by her birth control.
“I used to be more open to friendship and a people’s person,” Ortega said. “Now I pick and choose who I want to spend time with.”
According to Qualls, picking the right birth control differs with each patient.
“There are a variety of factors to consider before deciding which method is best for a patient,” Qualls said. “Efficacy, hormones, reversibility, side-effects, lifestyle… convenience.”
The Danish Sex Hormone Register Study, a nationwide study that includes all women living in Denmark, revealed that the risk of suicide was triple for women on birth control. The IUD had the second highest risk for suicide attempts.
“Use of hormonal contraception, especially among adolescents, was associated with subsequent use of antidepressants and a first diagnosis of depression,” the Danish study states. “Suggesting depression as a potential adverse effect of hormonal contraceptive use.”
In an OU Health Service brochure explaining the patient’s rights and responsibilities, it states patients should “expect reasonable continuity of care and be informed by your health care provider of possible continuing health care requirements.”
Handy said she was blindsided by Mirena and its side-effects. Handy’s life pattern isn’t corresponding with her current endeavors. As a senior ready to take on the world with success as a cosmetologist and an intern for the Brides of Oklahoma publication, Handy believes her worsening mental health is due to her birth control.
“For a long time, I thought that this was normal,” Handy said. “We are strong women so we just tough it out. It never occurred to me that wasn’t how it was supposed to be, that you’re supposed to live a normal life while not having children.”
*Name changed in order to protect true identity