When I saw the blood in the toilet bowl, I decided it was time to go to the emergency room.
I had been doubled over in pain for almost three hours. It started off as course normal: I had gotten used to semi-regular stomach issues that left me stuck in a bathroom as my abdomen twisted. I assumed it was just the way my body behaved. I had thought I might be dealing with irritable bowel syndrome, but never sought a diagnosis after several doctors didn’t seem concerned during my annual physicals.
The blood, however. It was new.
At the hospital, I was immediately escorted to the exam room, where I received fluids and blood tests. Some time later, a doctor came in. He, like all the others before him, was carefree. After normal test results, he sent me on my way with a suggestion to see a specialist.
The pain eventually subsided, but the blood didn’t go away right away. For days I held my breath every time I entered the bathroom. My follow-up with a gastroenterologist didn’t last two months (thanks to the health system!), but something nagged at me, telling me that I had to go sooner. I’m so grateful that I listened to that instinct.
I found someone who was able to see me, and when the bleeding had almost subsided by then, he scheduled a colonoscopy. The preparation was miserable (if I never eat lemon jelly again it will be too soon), but the anxiety was even worse. The day of my procedure, I remember enjoying the anesthesia for making me lose my mind a bit. When I woke up, my doctor gave me unexpected news: I had several ulcers on part of my colon.
Several biopsy results and an MRI later, he came to a conclusion: my birth control pill, which I had been taking constantly since the age of 17, might have been the cause.
This diagnosis was essentially a best guess. Biopsies, blood tests, and MRIs ruled out conditions like Crohn’s disease, blood vessel problems, and ulcerative colitis. Tests showed that the ulcers were due to an ischemic eventthat’s why I was in so much pain before going to the ER.
Usually, this problem occurs in older people. An ischemic event occurs when the blood supply is reduced to a certain part of the body. In my case, it was my sigmoid colon, which is the last part of the intestine. It is rare to see it in a young, otherwise healthy woman.
In some cases where this has happened to other people, the patient was taking the combined pill, that is, the birth control pill that contains estrogen. My doctor could not guarantee this was the reason with 100% certainty, as this condition is under-researched. What little research exists on the subject suggests that the estrogen in the pill might be to blame, but it’s “not clearly understood”, experts say. My doctor’s other theory was that I had some infection that was causing the ulcers.
Anyway, he urged me to switch to another birth control method as soon as possible, just to rule this out as a possible cause. Without birth control pills or an acute infection causing the problem, my bowels should heal and my blood flow should return to normal. I don’t have an official aftercare plan in place yet, but I imagine my gastrologist will want to check back in the near future to make sure everything is healing as it should.
My doctor told me I was lucky my trip to the ER didn’t reveal anything more serious. The worst (and very rare) scenario was the risk of intestinal necrosis, which is when cells in your colon die due to reduced blood flow. It can be fatal.
Until that moment, I thought a diagnosis would be liberating. However, it ended up being crippling.
I had taken the pill almost 15 years ago to fight acne and cramps during my periods. No one gave me any information at the time beyond “take it at the same time every day”. Overall I was happy with it. My skin cleared up. My periods have become more bearable. I haven’t experienced any of the intense side effects that some of my friends have had over the years. I continued to take the same prescription in college and then when I moved to New York.
“The pill was almost like a security blanket for me. I never considered any other option after I left my initial appointment; it never even occurred to me that there might be underlying health effects.
The pill almost felt like a security blanket to me. I never considered any other option after leaving my initial appointment; it never even occurred to me that there might be any underlying health effects. The doctors never told me about it; I haven’t read the packets that come with the medicines, which are as thick as a book; and the benefits certainly outweighed the potential risks. Now I was there over a decade later, and it left me cold.
You would have thought that making the choice to go off the pill would be relatively easy―after all, my health was at stake―but it wasn’t. I agonized over the idea of hormonal acne taking over my face, just in time for my wedding in May. I cried at the thought of dealing with painful and unpredictable periods. I dreaded the most likely excruciating insertion of an IUD, which was my first-choice alternative if I eventually made the decision to continue taking contraceptives.
After a ton of deliberation and no more urgency from my gastro, I stopped taking the pill and switched to the hormonal IUD, that does not contain estrogen. I am still very much in favor of birth control in all its forms, including the pill. If I could still be there, I would be. I would just like to know more about the drug that I had been taking for 15 years. I wish there was more research on this for cases like me, so women can get a definitive diagnosis instead of a best estimate. We can’t make informed decisions about our health care if our doctors don’t know what to do as they try to help us.
Fortunately, my gastro did as much research as possible until he found a logical and satisfactory explanation. I was shocked that he made the connection. My gynecologist too, when I told her (and after reviewing my case, she agreed with her assessment). Other people won’t be so lucky to have a team of medical professionals spending time looking for a solution, especially if there’s very little data to back it up. This is purely speculative, but I guess if Viagra caused reduced blood flow to the colon, there would probably be a lot more research on this.
It’s simple to advise people to be their own health advocates, but it requires a certain level of privilege: you need to have health professionals who believe you when you say something is wrong. You need to be able to confer with doctors who are willing to think outside of the mainstream explanations. You must have health care coverage to see specialists in the first place.
It’s only been a month since I stopped birth control, and thankfully I haven’t had any bleeding or stomach issues since my initial incident (nor have I had the other side effects I was worried about – please send good vibes to my skin). I don’t know if it’s a coincidence or if it’s because we targeted the problem. I hope that my diagnosis is correct and that changing contraceptives is the solution to my problem.
Women’s health care ― up to the level of research ― is still far from what it should be. This is especially true when it comes to birth control, but it’s also true in too many other areas. We need to stand up for our health and be prepared to ask the tough questions ― sometimes again and again ― and push back as often as necessary until we feel heard. I was lucky it didn’t cost me my life. Someday someone else may not be so lucky.
Lindsay Holmes is the Senior Wellness and Travel Editor at HuffPost, where she oversees health and travel content for HuffPost Life. She was selected for a National Press Foundation Mental Health Fellowship in 2016 and has moderated several panels on mental health. She is passionate about how the media can responsibly cover mental illness and has consulted on professional guidelines for reporting on suicide. She earned a journalism degree from the University of Central Florida in Orlando and is now based in New York.
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