Meet Anna: Cervical Ectropion, PID & an IUD nightmare

My journey with gynae issues and contraception started back when I was 15 and became sexually active (I started my period the year before when I was 14). I was with my first boyfriend and decided it would be a good idea to go on the pill - and this is when the problems started. Not every time, but occasionally, when I had sex I would bleed during/after sex, sometimes it would be a small bit of spotting and other times the bed would look like the flag of Japan. As I still had my period while I was on the pill I attributed this bleeding to me miscalculating my cycle and coming on earlier than I expected, so I didn't get the problem investigates, I ignored it and carried on as normal.

That relationship ended when I was 17 and I remained single for the next two years, in that time I came off the pill as it was no longer helping me with my PMS. I'd started getting sore/swollen boobs again, cramping, monthly episodes of depression/suicidal thoughts, and I had put on a fair amount of weight. I had also missed letting my body be 'natural' and not interfered with by artificial hormones. For a while this seemed like a good decision, it allowed me to get in tune with my body and recognise my natural cycle better, understanding my physical and mental changes caused by my cycle. But this didn't last, by 2018 (I was 19 at this point) my symptoms were starting to interfere too much in my day-to-day life for me to avoid some form of artificial/medical intervention, the monthly depressive/suicidal episodes were beginning to scare me with their severity and the pain in my boobs (I have quite a large chest for a small-ish girl, 30DD-E depending on the swelling) was agonising - even a t-shirt touching me was too much, let alone any form of movement.

Over the last few years since my relationship ended I'd still been experiencing pain/bleeding during sex sometimes and had started to get quite concerned by it. It was becoming embarrassing for sex to be a Russian roulette of whether I would bleed or not, not only this but I was also becoming concerned about my health as all research I did on that kind of bleeding didn't reassure me. The big C word (cancer) kept cropping up in my research and it was weighing heavily on my mind. So I decided to go to the doctor and have some examinations done, tests were done by my GP, I was referred to a gynaecologist, I had more tests and scans, to which the doctors could find nothing. I was dismissed, effectively being told "we can't find anything, so go away and if you're still having problems in 6 months time come back to us and try again". As I was under 25 one test they never did was a smear - despite multiple requests from me, due to my age. So being dismissed with no diagnosis when I was showing symptoms and not being allowed a smear test upset and angered me.

I hoped maybe going back on contraception would help with the bleeding. I didn't want to go back on the pill so I started looking at other option, I decided on the IUD (Mirena Coil) after doing a fair amount of research. I had the coil implanted in April 2018, the procedure was uncomfortable but not unbearable (after all the exams/scans I'd had to investigate the mystery bleeding I was quite used to speculums and random doctors sticking their fingers inside me). However the doctor that implanted my coil made a mistake, the coil was contaminated, and within 24 hours I was being rushed to hospital as I was in unbearable pain, unable to see or breathe, and flitting in and out of consciousness with a raging fever. Bacteria on the coil travelled straight from my womb into my bloodstream and I ended up with Pelvic Inflammatory Disease (PID) and a septic blood infection.

Thankfully it was caught early and I didn't suffer from full body septic shock. I did however end up with permanent damage to my eye sight, I'm now a full time glasses wearer after having 20:20 vision all my life, and have a much weaker immune system. When I became ill I was at the peak of my physical health, I'd never been in better shape, following my time in hospital I struggled to walk up stairs for the first few weeks of my recovery. I was shortly diagnosed with an anxiety disorder and PTSD and spent the next year in therapy processing what had happened to me and dealing with the mental and emotional impacts of sepsis. What I had struggled to get my mind around most was that getting the coil implanted was such a routine procedure, it was done at my GP surgery - not a hospital, it didn't require anaesthetic, it should have been so simple, yet it left me in hospital fighting for my life. It's now been three years since this incident and to be honest I still don't think I'm fully mentally/emotionally over the ordeal.

In spite of all of this, once I was recovered enough in the summer of 2018 I tried again to have the IUD fitted. Again, the procedure was uncomfortable but bearable, and as I had it fitted in a hospital gynae ward this time I even had some local anaesthetic (which didn't really do anything but hey-ho!). Despite the horrors of my first IUD, this one has been a dream. For the first two years of having it my PMS went away completely, I felt level and steady with my body, no monthly fluctuations in mood/pain/weight and I had no periods! I did however still experience unexplained pain and bleeding during sex...

Fast forward to 2020, I've been on the coil for two years without issue, I bleed occasionally during sex but it's infrequent enough to be ignored for the most part (I do have the occasional breakdown immediately after sex when I see the bedsheets, my thighs, and my partner covered in blood, terrified of what might be causing it - the C word is still floating solidly around in my mind). In spring of 2020 I start to notice my PMS coming back, so I speak to my doctor about having my coil replaced (they usually last for 5 years but can become less effective for PMS after the 2-3 year mark) but due to Covid-19 coil replacements aren't taking place. So my doctor puts me on the pill to give me the hormone boost I need to control my emotional/mental symptoms - it works!

I stop having boob pain and cramping and all the fun emotional problems I'd started to encounter again. But what also happens is the sex bleeding gets worse, a LOT worse. It goes from being every now and then during sex to every single time, and from mild spotting and occasional heavy bleeding to serious, bed sheet ruining, clotted, continues for a few days after sex bleeding. And I begin to get very worried. Not only am I becoming increasingly concerned about my physical health, but I am also in a fairly new relationship and it is becoming quite a problem in our sex life. I am very lucky and my partner is incredibly supportive and understanding and patient, when I breakdown at the sight of the blood he holds me while I cry, washes the sheets, puts me in the shower and takes care of me. When the bleeding became too often to ignore we stopped having sex and he could not have been more supportive in that decision.

It's time to go back to the doctors again and push for some answers this time, with my partners support encouraging me to keep going for answers I'm able to be referred to a gynaecologist by my GP. They discover I have a cervical ectropion (CE) - cells from inside the womb growing out onto the cervix and down into the vagina, which are highly sensitive causing pain and bleeding when touched. I'm filled with relief at finally having a diagnosis for the bleeding that's plagued me for the last seven years, but I'm also confused and a bit angry. If this is what's caused my bleeding and pain for all of these years, how did none of the exams I'd had performed over the previous years show this up? How can something so obvious be so easily missed?

What I also discover that angers me further is that hormonal contraception can not only cause cervical ectropions, but can also increase the severity of them in women who already suffer with them. All of which I discovered through my own research, not from information given to me by my doctor. So my doctor prescribing me the pill while I already had the IUD directly caused increased severity of my CE, causing me months of emotional distress and physical pain. I stopped taking the pill at once. And in December 2020 I was able to get some treatment for me CE, without anaesthetic my gynaecologist performed a silver nitrate treatment on my cervix - silver nitrate is applied to the cell growth and it chemically cauterises the cells. If this sounds painful, that's because it is. The female reproductive system is one of the most sensitive areas on the human body, and having that chemically burned to cauterise a cell growth without pain relief was excruciating.

The thing with CE is that for some people they come and go without causing too much interference in your life, some don't need treatment at all. However some do need treatment, and again, sometimes that one off treatment will work and the cells will never grow back, in other cases the cells do grow back, they could grow back in 10 years time or they could grow back immediately after you've finished healing. As of January 2021 I am still in recovery from my procedure and am yet to know whether the treatment worked for me. I've developed an iron deficiency from the amount of blood I've lost this past month of recovery - I get light headed and dizzy standing up/walking, I am fatigued and sleeping between 10-12 hours a night out of exhaustion, and am constantly freezing (not great when you live in Yorkshire in the winter!). Not only have I developed an iron deficiency, but since having PID and sepsis back in 2018 I have become incredibly susceptible to infections and have now also developed an infection to my cervix.

Infections are annoying and worrying at the best of times, but when you have a history of developing sepsis from infections in the current area that is infected and hospitals being over max capacity due to Covid and therefore unlikely to be able to treat me if this infection also turns septic, it is terrifying. I am currently clinging to my antibiotics and living in fear, praying the infection passes and I am able to heal. Looking forward past recovery is also shrouded in mystery and concern - will the procedure have actually worked? Will I be able to resume my sex life with my partner? Will my CE return - if so how long until it does - a few weeks, a few years? Will I be able to become a mother? PID can cause infertility and due to my age (currently 22) I have been denied fertility tests to put that worry at ease.

At the end of this very long tale, I guess what I want to put out there is: 1. You're not alone, whether its CE, PID, PMS, or any other fun gynaecological issue us women have the joys of dealing with, you're not alone in fighting it. 2. Keep pushing for answers, it's so common for doctors (male or female) to push off women's issues, not enough research is done into them and they're not taken as seriously as they should be, but if you are suffering keep pushing for answers. It's taken me seven years to get any answers but I finally have a diagnosis and have started a treatment plan which will hopefully finally close the book on this awful chapter of suffering. Hopefully one day I'll get to become a mother and all the struggles with my womb will have been worth it.

You can follow Anna on Instagram at: @annaherridge98

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