How Birth Control Works

I have a degree in Biology. It totally makes me capable of discussing these sciencey topics with you. I now know exactly how birth control works and I am ready to impart this knowledge. You’re welcome.

I decided around 29 years old that I wasn’t ready to have kids.  My husband said he wanted to have a kid that year. I said I wanted a divorce. I wasn’t ready. I felt better prepared for a divorce, knowing full well that heart break pain is temporary & kids are like a way way way more permanent type of pain.

At 37 I am still pretty confident that this isn’t the year for me to have a kid. Although admittedly I feel a little more flexible around this than I did at 29.

29 I was all “hell no”. 37 is more like “eh, maybe.”

Notice how I didn't age really from 29 to 37?
Notice how I didn’t age really from 29 to 37?

So I had an IUD put all up in my uterus the year I turned 31. Recently it was the 5 year anniversary of my IUD insertion, which can only mean one thing! P A R T Y! Bottles of wine, gift bags full of maxi pads and tampons and small devices that can go into your uterus, but probably shouldn’t, just like an IUD. You know like matchbox cars. See you guys, having a uterus is JUST like having a kid.

GET THAT OUT OF YOUR MOUTH!” If you only knew how I often I say that to my uterus.

Get that out of your mouth!

No really. The 5 year anniversary meant that it was time to change my IUD. As in rip the old one out and put a new one in. After 5 years the IUD I had was no longer releasing the period stopping, cramp stopping, food craving stopping, hormone stabilizing, keep me from being a PMS nightmarey bitch, hormones. I knew it was time when I found myself crying in bed one night, asking myself, what is this salty fluid falling from my eyes, why am I so bloated and why the fuck do my boobs hurt SO MUCH?? OH MY GOD I AM PREGNANT. FUCK.

Wrong. (I literally took a pee-on-the-stick test to prove this you guys. That is how much crying and sore boobs freaked me out after 5 years of forgetting what that was like.)

Clearly hormones are wearing away on this damn IUD. This describes:

  • my ridiculous food cravings of hot Cheetos and chocolate stuffed Oreos all in the same bite
  • sore boobs
  • crying at toilet paper commercials
  • all the feelings all the times
  • inordinate amount of facial hair
  • nipple hair
  • expanding waist line
  • toe hair
  • desire to wear nothing but yoga pants all the time
  • less white teeth
  • wrinkles
  • ability to smell people’s breath before they open their mouth

Excuse me, my science background has led me to believe the striked out items are a result of being 37 & probably turning into a man, not my old IUD.

Next steps. I make an appointment with the OBGYN and have my new IUD ordered. I am ready to feel like a normal, non-feeling, lady again. I am taking charge of my reproductive health. This is reason to have a party. Until I have this faint reminder of how painful the insertion procedure was 5 years ago. Didn’t it suck pretty bad? I can’t quite remember but I do remember there was pain. Huh. I guess I will worry about that when it gets closer to the appointment.


I always prepare for my OBGYN as if I am going on a super hot date. I shave every nook and cranny. I do dangerous yoga in the shower to reach the areas where her face & hands will be. I use my best smelling lotions and creams. I wear perfume. I put on cute socks and underwear. Why? I don’t know. She doesn’t even see the underwear and it isn’t like she is showering me with gifts or love. What do I get in return? A chair with stirrups and a paper blanket. A paper blanket. Usually I have on so much lotion and am such a hot sweaty mess that the paper blanket sticks to me. It is not romantic. Still, none-the-less, I prepare the same way every time. She will not speak ill of my privates to the other doctors in their doctors lounge.


On the way to the appointment I pop 800 mg of ibuprofen and ponder asking for an epidural upon arrival. I mean, ladies get those to have a baby and I am having something pulled out of the same place where babies come and something forced up into the area where babies come from. See science. I am totally qualified for an epidural based off this theory.

I am brought back to the room where my procedure will be done. It is decorated in a horse motif. Ahh, the ever relaxing vision of stirrups in front of me AND hanging from the wall. Look there! Horse paintings abound! Boy, if this isn’t zen. I don’t know what is. I am practically “Ommmmmmmming” my way right into the chair. Neigh, in fact, I am not even walking, more like floating. I am the most relaxed I have ever been. I might even take a nap.

Folded nice and neatly at the end of the table is my paper blanket. She loves me you guys. She really does.

I disrobe from the waist down, pull the paper blanket over me and wait. The doctor walks in. My heart is racing. This is going to hurt. I am not properly medicated. Apparently, they can’t give you an epidural for this less than 10 minute out-patient procedure. Stingy bastards. My hands are sweating. The blanket is sticking to me. I am as white as my paper blanket. The doctor is between my legs, getting things set up, trying to make small talk.

Doctor: What have you been doing for fun?

Me: NOT thinking about the thing you are about to force into my vagina, through my cervix and insert into my uterus. *shudders*

Doctor: Oh honey. You’re a big pussy. (Actual words that come out of the hole in her face.)

Me: Excuse me? What did you just say? I have a big pussy?

Doctor: You are a big pussy.

Me: As in I AM a big pussy? *gestures to vagina*

It has now become the “Who’s on First” of gynecological appointments.

I am totally all in my head now about my vagina size and wonder what the hell she actually says in the doctors lounge about me.


I ask her to please stop talking to me and to just let me know when I need to take the big breaths. She tells me that this is all in my head, then she counts out loud “1, 2,”  and rips my old IUD out before she even gets to “3”. She holds it up like a trophy before I can even process what the hell has happened.


Hot tears fill my eyes and spill down the side of my face.

That was tricky of her to do it before I could take a full breath in, let alone release it, but maybe the better way to handle it? Less anticipation?

All I can muster to get out of the hole in MY face is “that isn’t what I want. Please tell me when your doing something to my VAGINA so I can breathe, like a big breath. Please.”

She is still holding my old IUD up in the air. I can only assume she is waiting for me to acknowledge it. I am cramping so much and in so much pain, there is a clamp holding my cervix steady, it feels awesome. I don’t really want to vomit on top of all of this. You can only imagine what something that has been in your uterus for 5 years looks like. I refuse to really look at it. I groan and cover my face, pushing hard on my eyelids to feel something other than very aware of my cervix. At the risk of shooting the clamp out of my vagina I literally yell at her:


She tells me to take a deep breath and again before I can even breath in, she rams the new device up in me like a hot poker in a matter of a few seconds. It was fast. It hurt. MUCHO. I don’t understand why this has to hurt so bad?  I don’t understand why they say take ibuprofen before the appointment as though that is actually going to help. Why was I told before my first IUD and this second one that I can head back to work immediately after? That the pain is manageable. Am I crazy? Do other women not feel this way from having your cervix forced open, held that way, while something is shoved through it into your uterus. This sounds violent right? It is violent, right? Why don’t they tell you how violent this all is, to bring a friend, to have someone drive you, to have someone hold your hand, and to buy you a McDonald’s happy meal afterwards (toy car please)?

She wraps everything up, says a few pleasantries and leaves the room all before I can even blink away the tears. I must be crazy for that to hurt so bad, right? I take a minute to catch my breath. I pull myself together enough to peel the paper blanket off of me & get out of the stirrups. I feel like vomiting and I am shaking all over, this is not an exaggeration. I take a picture, evidence of the pain for when I need a reminder before the next appointment.

I’m not wearing pants. Also a better view of the wall stirrups and horse painting.

So now I get it. It has been a few days since the procedure. I might have a huge vagina that everyone in the doctors lounge is talking about. There are cramps happening in my pants as if I am going to give birth to an entire fleet of matchbox cars. I have PTSD around the word “insert.” I have decided that I am never having sex again. Clearly, this is how birth control works.


Side Note: If you’ve had a baby this procedure is apparently mucho easier b/c your cervix and uterus are “floppier.” I don’t know. They sure make you feel crazy for feeling any pain. When really, it is pain. All pain.


8 Comments on How Birth Control Works

  1. Lisa (Lewis) Paulo
    April 29, 2015 at 12:00 am (9 years ago)

    God, I love reading your writing. You’re right up there with Insane in the Mom Brain for me. Hilarious. Hope your lady parts are on the mend!

    • Joanna
      April 29, 2015 at 12:27 pm (9 years ago)

      Lisa! Thank you! I love love love Insane in the Mom Brain too.

  2. Ondrea
    June 16, 2015 at 10:51 am (9 years ago)

    Wow, I loved this article, though I am now slightly dreading Dec 2019 when I have to have my IUD replaced. But it probably feels better than having a baby pulled out of my uterus, so I’ll take it!

  3. nocoaster
    June 16, 2015 at 12:34 pm (9 years ago)

    I just went through the exact same thing you did. You described this perfectly. And made me laugh. And made me realize it really is all worth it. and it wasn’t “just me” feeling like the whole process is incredibly painful. Yikes! Thank you, m’lady!

  4. Sandra D. (@SFBayAreaGirl)
    June 17, 2015 at 3:38 pm (9 years ago)

    Verrry Lol’y. Loved it. I have had my IUD for yrs. I’m beyond the point where I even need it (meaning, menopausely or sexually, as I’m in one, not in the other, and I need to have this thing removed already! Anyway, I remember having my iud inserted. Pain for a few seconds, then done! Thankfully (after having read your story) I have access to some good pain killers and will use them on my next appt when they remove this thing. Thanks for hilarious story. I’ll follow.

  5. Vanessa vdH
    June 19, 2015 at 1:13 am (9 years ago)

    So good. So, so good.

  6. BelleP
    June 23, 2015 at 12:05 pm (9 years ago)

    SO RELATABLE! I changed my Mirena out for the non hormonal Paraguard after my 3 years was up. Let me tell you, I miss not having periods! And I hate these new 5 tampons a day period episodes that make me feel like a waterfall.


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