Copper IUD Side Effects and Pregnancy Risk (Episode 410)

Full Transcript: Episode 410

Lisa Hendrickson-Jack: Welcome to the Fertility Friday Podcast, your source for information about the Fertility Awareness Method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery Charting Journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health, and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works, and how artificial hormones disrupt that natural process. I teach women’s health professionals how to utilize the menstrual cycle as a vital sign in their practices, and I host live coaching programs to help you achieve optimal fertility and health, because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. I know, I’m a busy girl, but I managed to fit it all in. This podcast is designed to empower you to take full control of your cycles, your fertility and your overall health. And I’m so excited that you’re here with me today.

Today we’re switching it up from the conception series last month. And I’m jumping into a brand new episode of my Pill Reality Series. Today I’m sharing my interview with Annalise and she is sharing her experience with the IUD. And so without further ado, let’s go ahead and jump right in.

And I’m really excited to be here today with Annalise. Annalise is a member of the Fertility Friday community and we connected — we’re pretty sure over social media, likely over an inflammatory post about contraception. So I’m really excited to have you on the show to share your experience. And I’d love to start with my favorite question, which is, you know, when did you have your first period and let us know a little bit about how your cycles were and how you manage your fertility. And then that can lead us into your experience with, I think it was the copper IUD or it might have been a couple.

Annalise: Yeah. So I got my first period when I was 12. It was October. I remember it being like — my mom was really excited and I was very embarrassed, but it was overall a good experience. And my cycles were pretty easy. I don’t actually remember what they were like that first year or so, but up until when I started messing around with contraception, my cycles were easy, regular, painless. My only concern was that I was a swimmer and I was always very concerned about swimming on my period. But besides that, it was easy.

Lisa: Yeah, that’s — it’s funny that you said October because I had my first period in October. And the reason that I remember, because it kind of feels random, I’m sure there’s plenty of women listening who are like, I don’t remember what month it was. But I got my period in a church. I think my friends were being confirmed. I feel like that’s memorable. If you start bleeding for the first time in a church, and then I went over to my friend’s house and on the TV was The Hunt for Red October, and it was October and obviously the red part. So that’s why I remember. All right, so your periods were straightforward. I think any swimmers listening can appreciate that. It’s kind of terrifying how you’re going to sort that out. So let us know what you did when contraception started to be an issue for you.

Annalise: Yeah. I mean, swimming actually didn’t end up being too big of a deal because I noticed with my body, like when I was in the water, I didn’t bleed, actually. It was like gravity would kind of just kind of hold me up and then I would start again when I got out of the pool or the ocean or wherever I was swimming. But yeah, so I started taking the birth control pill — I don’t remember which brand — when I was 16. I took it for about six months and then stopped because breast cancer runs in my family and the pill increases your chances of breast cancer, especially when you’re taking it under the age of 20. And so I was like, okay, I gotta get off of this. And so that’s when I got on the copper IUD. My doctor was like, oh, you don’t want hormones — easy, like we’ll do this. And it sounded like the best option at the time.

Lisa: Well, and so then how old were you — around the same age, around 16 — when you had the copper IUD?

Annalise: I was 17.

Lisa: Okay. Yeah. I think the IUDs are such an interesting conversation. I mean, I feel like there was a time when doctors were more hesitant to recommend it to women before they had had babies. And now obviously that’s changed — it’s kind of now considered to be one of the best options because it’s definitely a set it and forget it, highly effective. So tell us about what that experience was like having it inserted.

Annalise: I had had several friends that had tried to get it inserted and failed — like it didn’t work and they were in horrible pain. And so I went into it pretty nervous. I remember being like really just scared that like something was gonna rip or that it was gonna be really painful. I remember it definitely being painful, and the thing was, the difference between this one and the later IUDs that I got was the pain didn’t really go away. It was just so inflammatory in my body. I felt like my body was angry at me. It was like everything in my body just hurt. Inflammation wasn’t localized — it was everywhere. It was my neck, it was my head, it was my feet. I was like, what is happening? For days, weeks even. And it began this process of me having painful periods for the first time in my life. It began this process of me like flooding the bed with my blood — I was bleeding so heavily. Whereas before, maybe I’d change a pad three or four times a day, but now I’d have to change it every hour or so.

Lisa: That’s a huge shift. Yeah. Well, so I have a real problem with this IUD insertion issue. From my perspective, it’s such a basic thing to offer women numbing. And even to potentially — they have ways to dilate the cervix a little bit. If you’re dealing with a 17-year-old girl who’s never had any babies, it would make sense to have a procedure as part of this process where they give you something the day before to dilate — these things exist. I’m not a medical doctor, but I know that they do have the ability to do these types of things, and/or giving you numbing agents. And you’re not the first person who I’ve spoken to who’s had a very dramatic insertion experience. Some women say very few but there are a few who didn’t really experience a lot of pain. But several of the women who I’ve interviewed have shared that this pain is like they can feel it for a week or two or whatever afterwards, and that’s obviously your case. So how long did you have it inserted? And also, did you share these side effects and changes with your doctor, and if so, what was the response?

Annalise: Yeah. I had that IUD in for about eight months. And I did go to my doctor during that. And I was like, is this normal? Looking for kind of validation. And I received validation that it was normal, that it was the IUD, that there wasn’t actually anything wrong with me. But I wasn’t offered anything other than like Advil to help with the pain. And so that was disappointing. And so I had about probably seven or eight cycles of this — eight months having it in. And then one cycle came and my bleeding was all of a sudden really light and there was horrible cramping, unlike before. I was in college now. And I remember walking to class and I was like, passing out, losing consciousness. And I thought I was dying, quite honestly. I couldn’t figure out what was going on. And so I went to the nurse on campus, and she gave me a pregnancy test and it came back positive. And we did the blood test and it came back positive. And I was like — are you freaking kidding me? Like the whole reason I’ve been putting up with this pain, this bleeding, these horrible cycles is because it’s supposed to be the most effective contraception on the market. Set it and forget it. And here I am sitting there, 18 years old, with an IUD, and pregnant. It was the most mind-blowing and awakening thing that’s ever happened to me.

Lisa: Wow. And so did the pregnancy continue or —

Annalise: No. When they took the IUD out, I started to miscarry. I just started bleeding really heavily as they took that IUD out. And then I did go in for a D&C to make sure that everything was removed.

Lisa: I’ll pose the question to you — I’m curious now. When you had the IUD put in, did the doctor go through potential side effects with you at all? Like even the potential for heavier bleeding? Did a conversation take place about potential side effects?

Annalise: I believe it did. I was 17 at the time — this was a while back. I believe that a conversation did happen where she was like, some people experience heavier bleeding, but I do remember her saying, but you are someone who has light bleeding so that shouldn’t be an issue. And she was like, and some people see more cramping, but you’re a person who doesn’t really have cramping so it shouldn’t be an issue.

Lisa: Yeah. Well, and with that, with the IUDs — the copper IUD is even listed as an emergency contraceptive. It’s literally listed as one of the highest possible efficacy. But the point that I always think is really important to make is that the side effect that I think the doctor would probably never even consider saying is that you could conceive. And with the IUD, it’s the worst because the IUD doesn’t require you to do anything. So you’re completely relying on the effectiveness of this device. And one of the things that struck me when you said that you had all this cramping and light bleeding — I was thinking, where’s the blood? For anyone listening, going back to the vital sign: the menstrual cycle is a vital sign. I feel like we always need to be paying attention to stuff like that.

Tell us a little bit about how that was with you, with your partner and your relationship. What was the fallout of this at 18 in college?

Annalise: So my partner and I at the time, we weren’t dating. We did go on to date for a couple of years after that. But at the time we weren’t actually together, and it was finals week of my freshman year of college. And yeah, it was quite a time. But I actually feel really empowered by how everything turned out. It was the first big decision of my adult life. It was the first decision that I knew I had to make on my own based on what was best for me. And like, coming from a home and a background where I was really taking care of other people, to really put myself front and center like that, and to know with absolute certainty what I wanted — that was such an empowering opportunity for me. And even going through the procedure of an abortion, even though I was already miscarrying — like, we needed to help it along, we needed to make sure that all of the products of conception had been moved out. Even that experience was really enlightening. I’d always told myself that I was the type of person who would never get an abortion. And I had a lot of judgment around it. But when I knew that I was pregnant, it felt so clear. There was not a question in my mind of what I needed to do. There were lots of questions of how I was going to do it, because I hadn’t been educated on what that procedure looks like, what the options are, what it would cost, how I would even get to an abortion clinic. I didn’t have a car. So there were a lot of variables that needed to come together. But it was beautiful — the show of support from friends. I remember being very nervous about who I could tell and who I could ask for support. But everyone that I talked to was so supportive, and most people had a story — they’re like, oh well, I had an abortion or my mom had an abortion — just really validating that that was an okay choice.

Lisa: Well, and I don’t know if this question is relevant, but I’m still curious. Did you tell your parents? Did you tell your mom or dad?

Annalise: Kind of, yes. So it’s come out in phases with my mom — my dad’s not really in my life anymore. But after this whole thing, I was trying to decide what to do for contraception after this, and I remember talking to my mom about it and I was just kind of in hysterics crying. And she was like, I really think that you should just go back on the copper IUD. And I like just couldn’t keep it in anymore — I blurted it out. I was like, I can’t do that because I got pregnant with it in. And you know, my mom is very loving, understanding, also very religious. So you know, that did open up a conversation around what happened. And so I didn’t tell her the whole story — she might listen to this podcast and I think she’d be okay with it at this point. But I did tell her that I was pregnant and that I was later not pregnant.

Lisa: Well, and in your case, it sounds like it was kind of in the middle. Because if you had to get this copper IUD removed and then you started bleeding — even in a case where a woman has a miscarriage, if that miscarriage doesn’t fully leave her body, if all of the tissue doesn’t come out, it’s life-threatening. So it’s really important to be very aware of those types of situations and to be very on top of any type of unusual bleeding. Back to the vital sign piece — if you have bleeding or cramping, there’s not supposed to be bleeding between periods. Just as a public service announcement, the answer of what to do when you’re bleeding unexpectedly is to go to the doctor. You go to the doctor, you get an ultrasound. If you’re miscarrying or whatever the case is, you need to make sure that that’s taken care of, because it literally can kill you.

I mean, when you said that you had the copper IUD for eight more months after all of that pain — there was a part of me thinking, like, how could you put up with that much pain for that long?

Annalise: Yeah. I didn’t know I had another option at the time. I was like, I’m not supposed to be using these hormones because of my risk of breast cancer. And no one had told me about any sort of natural methods or fertility awareness. I didn’t really have a lot of faith in condoms.

Lisa: Can I ask why?

Annalise: It was just kind of hammered into me when I was receiving sex education when I was younger that condoms alone are not enough. They were like, if you are going to be having sex, you need to be using two methods, and it should be hormonal contraception and condoms.

Lisa: That’s so interesting. I find this dialogue really interesting just to hear how the actual literal data and information has not changed, but what the messaging is that we’re receiving is changing over time. And I think, of course, that it’s being promoted by the pharmaceutical industry — because there’s a lot of money in contraceptives. Personally, that’s my opinion.

I had one other question before we kind of move on in your story. You said that before your periods were quite light — you went from changing your pads three to four times a day to once an hour — and then you mentioned you had no pain, and then now you had all this pain. And you mentioned that when you went to your doctor, your doctor said it was normal. It’s not normal. With the copper IUD, there is plenty of research to show that one of the primary modes of action is this localized inflammation that it creates in the uterus, and that is part of the reason why it prevents pregnancy, in addition to the copper ions being toxic to sperm. Yes, women do tend to have increased bleeding and many do have increased cramping. But going from a zero to a ten, and having that level of discomfort, and to be told that that’s normal — looking back, do you think that it’s normal?

Annalise: Yeah. So I think at that age, at that time in my life, I lacked the vocabulary to actually tell my doctor what was going on. Like I just kind of went in and I was like, I’m bleeding a lot. I didn’t say I’m filling up a pad every hour because I didn’t know that was a metric that she cared about. I wasn’t taught what a normal period looks like. I knew what was normal for me at that point, but I was like, maybe this is just normal — I have friends that have really heavy bleeding, maybe this is just what’s gonna happen from now on. Which is horrible looking back on it. Like, I stayed on that for eight months. And if I hadn’t gotten pregnant, I would have stayed on it for longer. You can leave them in for up to 11 years. So looking back on it, no, it wasn’t healthy. But I think it speaks to the need to really educate young women on what a period should look like and how to have a conversation with medical practitioners — how to actually talk to them in a way that you’re going to get your point across, that they can understand what’s going on, the severity of what you’re experiencing. Because we’re taught to use very broad terms, like, oh, I’m bleeding a lot. And then I hear the doctor say it’s fine and then I leave. That’s not a helpful doctor’s appointment.

Lisa: That is really interesting. And on the one hand, I totally get why you’re looking back on that and saying, I should have said this. And now, for anyone listening, yes — if you’re going to the doctor, talk in their language, explain specifically how frequently you’re filling the pads so that they have a more clear understanding. But on the other hand, the doctor is the one that went to medical school, and they know when they’re looking at you that you’re 18 years old. So when you’re saying I bleed a lot, it’s up to them to ask — what does that mean? I would look back and be like, yes, I would have gotten better care had I expressed myself better. But ultimately, who was the one who was responsible for that situation? If you picture an 18-year-old girl terrified in your office — it was enough for you to call, to pick up the phone, to call the doctor, to make an appointment, to put on your clothes and go. So it’s not nothing that brought you there. And it just speaks to how, as women, I rarely have an interaction with a client or anyone who is female who hasn’t had an experience like this in a doctor’s office where something’s happening and whatever you’re saying is being minimized. It’s a huge problem. It’s a systemic issue. And it really is unfair to put the onus on the 17-, 18-year-old girl to have to describe things properly so she can get adequate medical care.

Annalise: Yeah. Thank you for validating that. I mean, yes — as a practice of being an empowered adult, looking back, like, what could I have done differently? Not fully putting the blame on others. But yeah, it would have been nice to have those direct questions and to have a relationship with my doctor where I felt comfortable really answering them.

Lisa: My perspective is definitely changing. As a parent now, if I’m literally sitting in front of a 17-year-old — it’s literally a time when we are not as mature as we’re going to be. It’s literally a time where we just don’t have as much information as we’re going to have. And it’s such a vulnerable time because we rely on our practitioners to support us.

So you did say at the beginning of this call that you had the IUD inserted two more times. So tell us a little bit about that.

Annalise: Yeah. It was traumatizing the first time. And so I had a couple of months there where I was using condoms and it just really didn’t feel safe to me to only be using condoms. There’s so much fear. I was like, if I get pregnant, my entire life is going to be derailed. And so I did a lot of research and decided to go on the Skyla, which is like the low-dose hormonal IUD. And interestingly enough, while this was happening, I started working with a functional medicine practitioner to help with depression. I was very depressed that entire year having the copper IUD in. And so I finally decided to get help. And I was able to go to a functional medicine practitioner — which I don’t think many 18-year-olds do. And we did whole blood panels. And I remember everything came back totally normal. And then she was like, but you want to look — weird, like your copper levels are really elevated. Like you have copper toxicity. I was like, oh, weird. And we both kind of moved on. But she never asked me about the copper IUD, it never came up. And years later, I was like, I wonder if that was related.

Lisa: Well, it could not be — I’m not the type of person that’s like, oh wait, you were on the copper IUD for eight months, oh look, your copper is super elevated — one plus one equals two, stop it. But interestingly, she didn’t bring it up. The copper toxicity is interesting because being on a hormonal contraceptive can also invert that balance between copper and zinc. So literally the copper IUD can do it, but also hormonal contraception — isn’t that interesting? And the symptoms of copper toxicity are tricky, because copper toxicity looks like a lot of other things.

Annalise: For me, it was showing up like low energy, depression, headaches — a lot of various things that we thought were thyroid for a while. And then like diving in, we were like, oh, it’s copper. And it really did start to get better when I started treating it. But yeah, at the time I’ve brought it up to several medical practitioners since then. And the general consensus in that community is like, there’s no link between copper toxicity and the copper IUD. And just to say that the copper IUD literally releases copper ions — and that’s one of the modes of action. Like, it literally releases copper ions. There’s research on how the copper ions interfere with the sperm transport and are basically spermicidal. If it’s literally a mode of action, it’s like one plus one equals two.

Lisa: Yeah, it’s so simple when you say it like that. But it’s hard when you go from doctor to doctor and they tell you basically that you’re crazy, you’re making it up. I think it’s always really important to think about people’s experiences and how — like if I’m a doctor and I insert copper IUDs on a regular basis but I don’t believe there’s a link between the copper IUD and copper toxicity — my belief is going to mean that I will never do a test on it. And a medical doctor may not necessarily do those types of functional panels to look at all those nutrient deficiencies because it’s not necessarily part of the paradigm of Western allopathic medicine. So legitimately, your perspective on this prevents you from ever seeing whether or not there’s actually a link. The functional practitioners, for example, may regularly and routinely run these labs in their practice and find that women who’ve been on the copper IUD are more likely to have this copper excess in the labs. And so again, you could have two practitioners, both excellent, generally speaking, very educated, generally speaking. But because of their belief, one of them is going to come to a different conclusion.

Annalise: Absolutely. And I think it just speaks to how much weight we put on medical. Again, this isn’t about throwing shade. But I always have the belief that if you’re having a health issue, you know your body better than anyone else. If something is not right, you are going to know. And if you go to a practitioner and they say it’s fine, everything’s fine, sometimes you need to go to a different practitioner or sometimes you need to try a practitioner of a different modality so that you can get a second opinion. Ultimately, until you’re better, you need to keep searching.

Lisa: This is called medical gaslighting. And ironically, someone telling you you’re fine when you’re not — is that helpful? No. So tell us what happened when you had the Skyla inserted.

Annalise: I don’t remember the insertion, so that means I either blacked it out or it wasn’t eventful. I had that one in for about three years — for the full term. And I didn’t mind it for the most part. There are a few things looking back — my PMS did get a lot worse. Like, to the point where for me, it showed up like whenever I was about a week out from my period and I saw one of those commercials where a veteran’s coming home from war, I would just start sobbing. I don’t know why. I don’t know anyone in the armed forces. I would just be losing my mind. That was only on that IUD. But besides that, what I did like about it was I was having a bleed, and that felt really good to me. But I never fully trusted it. I was always pairing it with either withdrawal or condoms. And even then, I was in a state of constant fear. My bleed would come a day or two later than I thought it would and I’d be freaking out. And so I got that one taken out, and then I went to Planned Parenthood to get another one put in. And when I got there, they were like, we can only put the Mirena in because of some insurance thing. And I was like, the Mirena is a higher dose of the synthetic hormone — I’m not really sure if I want that. But I was already there. I didn’t want to make another appointment. And this insertion, I will remember forever because they were training someone.

Lisa: Oh no.

Annalise: They were training this — the most gorgeous man that I’ve ever seen in my entire life. And meanwhile, he’s trying to figure out how to get an IUD into my vagina. They did ask for consent and I was like, okay, sure, whatever. And so he tries to do it and he misses, I guess. So they have to throw it away, start over. I’m in pain because it’s painful. They’re trying to open the cervix to get it in. And so he tries again, but this time to get a better view, I remember he put his hand on the back of my thigh and I was very sweaty because I was in pain. And he looked at me and he’s like, you are very sweaty. And I was like — how are you kidding me? How would you feel if I was about to take a toothpick and jab it into your penis? Do you think you might be sweating too? And so he misses again, and this one’s even more painful. And so at this point the woman who’s training — the doctor — is like, okay, I’m going to step in and do it. And so she did it and it was quick. It did hurt, but this time they had given me 800 milligrams of Advil and a heating pack. So once it was in, it was okay. But I remember that insertion process and I was just like, is this a joke?

And so I had that one in for about three months only. After that whole insertion process, I went down to Costa Rica and I was doing a yoga teacher training. And throughout those three months, I never bled. I didn’t have any bleeding and that bothered me. And at my yoga teacher training, we did a brief introduction to the four phases of menstruation — menstruation, the follicular phase, ovulation, and the luteal phase. And this young yoga teacher woman was standing in front of me talking about the four phases and how we’re a little bit different in each one, and what estrogen is, what progesterone is. Maybe a 15-20 minute talk. And I remember spiraling because I was like, I didn’t know there were four phases. I didn’t know anything about my body. And so I was talking to her and I was like, do you think the IUD impacts your cycle? And she would kind of laugh and she was like, of course. And I sat with that for the rest of the training. And I was like, I have not experienced my cycle since I was 16. I have not actually experienced what it means to be a cyclical being in a very long time, without the use of synthetic hormones or devices. And I’m living in a state of constant fear. This isn’t working. It’s not worth it. And so when I came back to the States, I was like, I’m going to get it out.

And then of course, like three days after getting it out, I met someone and I was like, well, now I have to figure out how to prevent pregnancy. And so I was like, okay, what are the hippies doing? I got so many weird answers — people making all sorts of tinctures, people using different devices, lots of herbal things, a lot more people than I thought relying on withdrawal. And so I just went through this exploration. I was like, who’s talking about this stuff? And longer than it should have taken, I found a copy of Taking Charge of Your Fertility. And that was really like the start of it for me. I was like, oh, there’s like science! People have done studies. There’s actually a way to figure out when you’re fertile, you’re not — it’s biology!

Lisa: Having that resource was incredible.

Annalise: And so I was self-taught for about a year, still using it very cautiously, never fully relying on it, because I really wasn’t producing a lot of mucus. And so that’s when I decided to start working with an HRHP — someone that I found online — and like learning about my cycles. And I was like, yeah, like I can do this. I can actually prevent pregnancy and not be terrified every month. And it’s like I look back now that I’ve like told that story, I’m like, I was so stressed out about that every day of my life, either in the forefront of my brain or in the back. And now it’s not. That fear isn’t here.

Lisa: That’s so interesting. I mean, I’m glad that you found fertility awareness after your journey. And when you were talking — part of your story, just like how scared you were regarding the condoms, because you were taught that they couldn’t be relied upon — I find it so ironic because for the same reason many women are on birth control is the reason that I wasn’t. For my personal experience, I actually feel a lot more in control when I know what’s happening in my cycle, when I know what day I’m on, when I know when I’m fertile. Because if I know when I’m fertile, then I can be really intentional with my chosen method during that time. And then I always know what’s happening. So there’s no pregnancy that would surprise me in that sense because I’m on top of the cycle. I’m really glad that you were able to find your way to that place where you can track your cycle and feel more comfortable — ironically — than when you were on some of those other methods.

Annalise: I mean, it was also such — similar to my experience with the copper IUD getting that out — like choosing to come off of birth control was one of the biggest decisions of my adult life. Really being like, I’m going to do something kind of radical here. I’m going to do something that most people in my life are telling me not to do. But it feels so right. I felt it in my bones, in my womb, in my body. I was like, I can’t do this anymore. And so that enthusiasm and that high of actually listening to my body got me through the learning phase, and even detoxing from the birth control. I was just so excited to be able to connect to my body in that way and to follow the guidance of my body.

Lisa: So for anyone who’s listening — someone who tuned into this episode maybe because they’re thinking of getting the copper IUD — for anyone thinking about coming off contraception or thinking about switching to a fertility awareness type method, maybe in conjunction with another non-hormonal or barrier method, what would you want them to know?

Annalise: Get education early. Don’t try to do it cheap. It’s so worth an investment to work with someone who has actually trained in this stuff — to educate you and help you interpret your cycles and make sure that your cervical mucus classification in the beginning is done properly. Each method, each app is going to tell you to do something different. Find someone that you think knows what they’re doing and hire them, pay them. That was the greatest decision that I made.

Lisa: I mean, I’m certainly biased because I did start with Taking Charge of Your Fertility. So I did chart independently for the first little while. But very soon after that I was right in there with trained educators and learning the Justisse Method right off the bat. And so it’s a game changer. It helps you to go from not really knowing what’s going on and having all these questions and not really having answers, to actually getting those questions answered and feeling a lot more confident about what you’re doing. So I certainly agree that yes, it can cost money and things like that. But I think that it’s important to consider making that investment, especially when you’re wanting to rely on fertility awareness as your primary birth control method — because it can work and it can be a method that you can use throughout your whole reproductive life. It really can work for people. It worked for me for all these years and it sounds like it’s working for you. So just to give some encouragement to the ladies out there.

Well, I want to thank you so much, Annalise, for coming on the show. This was great. I literally could continue talking to you for the rest of the day. I’m sure that I have at least 20 more questions. But thank you so much for sharing your story. There were so many aspects of your story, different experiences that you had. And so I know this episode is going to be really powerful for those who listen.

Annalise: Yeah, thank you so much for having me. And I can’t tell you how grateful I am for this podcast and all of the content that you’ve released in your book. I’m a student at Justisse right now. Having all of your content, it’s really helped me ground it in and make it accessible. You’ve just done such an incredible job.

Lisa: Oh, thank you. That’s so sweet of you to say. Well, thank you so much for being here. It was such a great interview, and I’m really excited to share.

Thank you for listening. If you enjoyed today’s episode, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/410. I hope that you enjoyed today’s episode. For more episodes in the Pill Reality Series, you can head over to fertilityfriday.com/pillreality, all one word. And for episodes in my Fertility Awareness Reality Series — those are on-air client sessions sharing experiences of women who are using fertility awareness, often transitioning off of birth control, many times avoiding pregnancy, sometimes trying to conceive. No one’s discouraging anybody from being responsible and using birth control. But ultimately we always have to be weighing that risk-benefit scenario and finding out what works for us. And that is the biggest takeaway that I hope that you take away as you listen to these episodes — which is that everyone is not the same. And so everybody doesn’t respond the same way. And what really, really worked for your girlfriend so well could totally just not be the same at all. You could have a completely different experience on the exact same medication. And so that’s what I’m always hoping that these episodes are bringing to light. And also that we’re listening to what women say, as opposed to ignoring what they say or downplaying it or pretending like their experiences aren’t real. With that said, I hope you have a wonderful week. And of course, as always, until next time.