After the Flood (reprise)

Today is day three of my period. I’m not wearing a tampon. I didn’t wear one on day one or two either. In fact, I haven’t worn a tampon for months, maybe even more than a year. These days my periods are so light that I only know they’re here by a very slight colouring of the loo roll. In fact, earlier today, knowing I was going to write this, I giggled when I wiped my hands and the juice from a blood orange left more of a mark on a tissue than an earlier bathroom visit had.

Things used to be very different. I used to plan my work diary to avoid leaving the house on day three of my period. If day three fell at the weekend and I was away I would take my own towels to wrap around me like a nappy in case I ruined a friend’s mattress. Dates, nights out, exercise – all of them would be embargoed if it was day three. Day three was when the floodgates opened. Literally.

Then in summer 2016 a pub conversation with Livvy set in place a chain of events that led me, five months later, to surgery. Nothing serious – just a simple 15 minute procedure to remove what turned out to be “a multitude” of polyps and insert a Mirena Coil to stop them coming back again. Today, I would delight in answering the white trouser question very differently!

Had that conversation not happened would I still be on that frankly horrible monthly rollercoaster, living in fear of public embarrassment? Or would I have eventually taken myself to the doctors of my own volition? I’d like to think the latter, but who knows; I was already putting up with ridiculous levels of inconvenience and had made it my normal. And too many women do this. One of the reasons I’m so glad to see Sub Bee’s new meme, Menstruation Matters is because it provides a place where we can all share our stories and experiences and where we think someone might need a gentle nudge to seek help or just a friendly word, we can help.

So is it all a bed of roses now? Not exactly, but it’s nothing I can’t deal with. Although my monthly bleeding is nothing more than mild spotting now, other things have changed. I rarely (ok – sorry – never!) had period pain but now I get very definite cramping. I’d hesitate it to call it real pain but because I’ve never experienced cramps before I do get a bit cats bottom mouth about them, especially as I cramp but don’t bleed. The most problematic change is emotional. When I was talking to friend around the time of the op and told her I was going for the Mirena Coil she replied: “ah, PMS to FMS!” I pressed her on this. Apparently FMS is fat miserable and spotty. These were the side effects she’d read about when she was researching her own procedure. Fat we’ll come back to. Spotty – I have been annoyingly fortunate on that front all my life. But oh my, miserable? Yes!

I’m not talking ongoing constant malaise but as regular as clockwork a few days before my ghost period arrives I get truly distressed about things. In the old days I’d get all ranty and cross, now I just get really really upset with someone-is-pouring-a-watering-can-down-my-face level of tears. It’s mildly annoying but unlike the hormonal swings of my twenties, when the pill didn’t agree with me, I feel more robust when it comes to coping with these dips. They just happen. It just is. It lasts 24 or 48 hours and then it passes. What I find most fascinating is they’re never irrational tears. When I used to get angry and rant, that was often about stupid pointless things of no consequence or out of my control and afterwards I would feel stupid. Now, I find myself intensely upset about things that I may have been trying to push under the surface for the rest of the month and then – boom! – in the same way a hot flannel will bring a spot to the surface and make it easier to pop, my cycle brings all that emotion up and out. It took a while to cotton onto my new patterns but now I have I am more prepared for them and I examine more closely what that emotional purge is telling me.

And then the fat thing. The official paperwork says fewer than 5% of women experience weight gain, although 5% of the number of women who have one fitted is probably a lot of women. I have put on a fairly significant amount of weight in the two years since the op. But I would be really really disinclined to say that’s coil-related, it’s almost certainly life-style related. Many people talk about ‘eat less, move more’ as a method of losing weight. I generally gleefully subscribe to the ‘eat loads, move loads’ method of making sure my clothes continue to fit! I’m lucky enough to usually enjoy good physical health and I love exercise so this isn’t usually a problem but a stupid accident on a bus last spring left my knee in a sorry state and seen me in and out of X-ray rooms and MRI pods. Of course, I haven’t tempered my eating or drinking to match my reduction in exercise – if anything I’ve done more of both in response to work stress. In short, I’m 99% sure consumption and lack of movement is the cause of my weight gain and that in time normal service will resume. However, if someone was to say to me it is all because of the coil, would I have it removed so my favourite clothes fitted again? No bloody way. Excuse the pun! I never want to find myself hiding in a graveyard washing my legs or cleaning my carpets at 3am again.

So that’s my before and after! If you’re experiencing periods that are disrupting your life, don’t be like me and wait years to get it sorted – book an appointment with your GP right now!

After the Flood

My periods started when I was 12. Summer 1987. My stepmum (who can be a bit Victorian!) put me to bed with tomato soup and a hot water bottle. I was thoroughly confused. I felt absolutely fine and was somewhat flummoxed about being sent to bed as if I was sick. Generally speaking the subsequent thirty years followed much the same pattern – not the being sent to bed bit, the feeling absolutely fine bit! For three decades I’ve never suffered any sort of PMT and can count on two hands (probably one, actually) the number of times I’ve had significant period pain. I occasionally get a bit teary or inhale a bar of chocolate a couple of days before I am due, but that’s the extent of the problem periods ever caused me.

Until about 3.5 years ago, that is. Up until that point my periods had always been light with a couple of slightly heavier days in the middle. Then, one Saturday in summer 2013, came the flood. It gushed. And when I say gushed I mean it flowed like water with clots the size of eggs. My flatmate at the time asked if I was having a miscarriage. A couple of hours later it was all over. ‘Odd’, I thought, then didn’t give it much more thought. Until nine months later.

A new cycle had started where every six to nine months I would have a catastrophic period. And when I say catastrophic I mean being stood with a friend in Covent Garden and feeling my jeans soak down to the knees within 10 minutes; changing a super plus extra tampon three times during a 15 minute train journey; wrapping myself in towels like a nappy and being afraid to fall asleep because I was staying in a friend’s daughter’s bed. And do you know what? I didn’t do anything about it. It just became the pattern I got used to and planned for. I knew if I was going to have a flood then nine times out of ten it would happen on day three and so when a few months had passed and I knew a heavy one was due I would start to adjust my plans for that day – not scheduling work meetings or social plans, sleeping on towels. When it happened I’d have a few hours of chaos then breathe a sigh of relief, knowing I had a few months respite ahead.

I don’t know why I didn’t do anything about it for so long. I am certainly not squeamish or embarrassed about these things. Avoiding their exact name to hopefully prevent Google showing a client my arse, for four years I have worked for the body that produces guidelines and sets the clinical standards, training and examinations for women’s health in UK and further afield. I have made training films for them, filmed caesareans and abortions, met women they support in Africa who have endured horrific complications in childbirth and who don’t have access to the simple things we take for granted – smear tests, contraception.

If I was pushed to say why I didn’t walk the five minutes across the park at the end of my road to my GP, I would probably say it was because I had found my way of dealing with it. Or that going to the doctors because of heavy periods when we see so much about the NHS being at breaking point was just, well, a bit lame. But it was lame not to go. And it wasn’t a body positive decision. For me, body positivity shouldn’t just be about accepting your natural shape and what you look like, it should also be about looking after the mechanics of your body so it works its hardest for you. Yet every few months I was adjusting my life to fit around a medical condition that was easily fixable.

So what happened? Well a few of us bloggers were out last summer when, with no word, I got up, left the pub and dashed to the nearest shop. Having had a flood only three months earlier I wasn’t expecting another so soon. Returning to the table to a chorus of ‘where did you go?’ I ended up sharing some of my horror stories. To cut a long story short the marvellous Dr Livvy imparted some sharp words of wisdom of which two things stuck in my mind: “Could you confidently wear white trousers during your period?” and “if not go to your GP and ask them to refer you for a scan.” Two days later as I stood in a graveyard washing my legs under a church tap I realised the problem was escalating and decided to heed her advice. Six months on I sit here having had “a multitude” (to quote the gynaecologist) of polyps removed. A Mirena Coil that went in as they came out should prevent them returning. The operation took half an hour, I was discharged within three hours and have had no pain or bleeding. The growths are at the lab but polyps are rarely malignant so that concern isn’t really on my radar. Do I feel daft for leaving it this long? Of course!

I already was, to be honest. Back in December, over lunch with the aforementioned client, I was talking about my upcoming op and confessed sheepishly to my years of ignoring the problem. She’s the clinical lead on the organisation’s global health strategy and often brings an international perspective to chat. Her response was to talk about African women being three times more likely to suffer fibroids which, if left untreated, can lead to a hysterectomy. With surgical facilities in many countries scarce or dysfunctional, more widely available Mirena Coils that could help prevent fibroids would have a profound impact on outcomes for many women. She also talked about cervical cancer being the fastest growing threat to women’s health in developing countries – 90% of deaths occur in countries where there is limited access to cervical screening. Her chat was a gentle reminder to me that in ignoring what was going on with my own body I was also ignoring what a privilege it is to have this advice and treatment readily available.

And for many women that advice and treatment is even further away now than it was when she and I had lunch last month. On Monday, as I slumbered happily under general anaesthetic having a quick, safe, free procedure, Trump re-enacted the Mexico City Policy. The policy means any international organisation that provides or promotes abortion services – regardless of how those services are funded – is prohibited from receiving US funds. This doesn’t just affect the provision of abortion, which would be bad enough. Organisations providing other women’s health services, such as contraception and smear tests, will lose funding for all their services if they also provide abortion services. Marie Stopes International has already said it cannot agree to the conditions. In the next 12 months its partnership with USAID would have helped them reach 1.5 million women in some of the world’s poorest countries. Its predictions on what the loss of its services could mean over the four years of Trump’s term are terrifying.

The world of women’s health was different when I left hospital than it had been when I arrived six hours earlier. These last couple of days have reminded me that we must be vigilant about our own health but over the coming years we will also need to keep supporting organisations who provide services to women around the world.