IUDs and Ashtanga: a cautionary tale, redux!

This is a reposting of a blog essay I wrote back in March of 2013 on my old Florence Yoga Blog. I'm including it here because of a recent request by Angela Jamison of Ashtanga Yoga Ann Arbor to share my story once more. Since I have written this post, I have shared my story with many students and many teachers of the Ashtanga practice, warning them of the risks inherent in these devices for all women - but especially those who practice Ashtanga. The risk of a severe physical and mental toll on women who use Mirena - and I suspect, other IUD forms of birth control as well - far outweighs the benefits. My recommendation: steer clear of IUDs, no matter what your age. 

I've loved the practice ever since my first led Half Primary class 16 years ago. I've struggled with it, loved it and at times, hated it, too - but I have stuck with the practice with little variation because I believe it's brilliant and it works for most humans - if you put the time and effort into it, that is. At one time, though, I literally was unable to do the practice, for about a year, because it hurt way too much. 

In 2004, I was looking for an alternative form of birth control, and an IUD called the Mirena was suggested to me by my well-meaning ObGyn. Placed inside the uterus, good for five years, the Mirena is a very small plastic device shaped like a "T" and it's impregnated with a low dose of hormones, so that you don't get pregnant. "Brilliant", I thought, "hook me up!" So, the device was inserted into my body, and all seemed well. Sex with no muss, no fuss, and no worries! 

I went to one of Nancy Gilgoff's adjustment clinics the following Summer, where she was teaching us Uddhiyana and Nauli Kriya. After demonstrating the how-to for us, she said, ominously, "If you have an IUD in, do NOT do Nauli Kriya. I'm not even certain you should do Uddhiyana Kriya, either." My ears perked up, and I raised my hand and said, "I have an IUD in." Both Nancy and Christine Hoar said, almost simultaneously, "You should have it removed."

My reaction was skepticism, "Yeah, well, sisters, I really, really am done having kids. So, the IUD is staying in." And, so it did.

In year two of the IUD, I stopped getting my periods, but also started noticing an increase in water weight. (Let's be frank: I was really bloated, all over.) I was practicing daily, rigorously, but not a bit of weight was coming off. Practice made me feel so depleted, I would compensate by eating too much. There also was a little bit of back pain now accompanying the lovely bloat, too. Nothing severe, but it was there.

In year three, I started noticing that I could barely move when I woke up in the morning. My back was becoming increasingly stiff, and practice was starting to become difficult. I was noticeably heavier. I had been practicing all of Primary and all of Second before the IUD, but at that point, even Sun Salutes were becoming difficult. And, I had to practice later in the day, vs. the mornings, because my back was just too stiff and painful early in the morning. After an afternoon practice, my back would feel better, and I would think, "Oh, Good, practice fixed it." But, then, I would wake up the next morning, wracked with pain and feeling like I was 80 years old. (I was 40 at the time.)

I went to a doctor, who could find nothing wrong, other than "muscle spasms." I attributed the worsening of the initial, tolerable back pain to lifting heavy furniture. The pain got so bad, I finally decided that it was the Ashtanga practice that was hurting me, so I stopped doing it completely, and thought I'd try some other form of Hatha yoga. For almost a year, I tried other styles. Yin Yoga. Good, but not great. Iyengar. Dull, with too much talking about "how" and not enough doing. Kripalu. Better, but, still not great. Svaroopa. No movement at all, really, and so, no pain, but then the pain would return. I even tried Anusara, which was not a fit. 

None of these practices addressed my physical needs, and certainly, none of them addressed my mental and emotional ones, either. I was getting weaker and weaker, too. Chronic pain, if you have ever experienced it, is extremely debilitating. You just don't want to move at all. After this fruitless search, I decided that the Ashtanga system was the most sane and wise, and the only one that addressed improving strength along with flexibility, and, even if what I was doing wasn't the traditional, "pure" practice, it worked better than all the other forms I had tried.

So, I did an extremely modified Ashtanga practice on my own (really, a series modeled on the Ashtanga sequences - but, no Sun Salutes, no vinyasas, a modified Primary with no forward bending beyond 80 degrees. Some of the first part of Second series, too, nothing beyond camel, `although the twists of Second series and Parighasana were very therapeutic, so I added those at the end of my practice. Shoulderstand sequence, once I hauled myself up into it, felt good and restorative, too. And, I turned to Vipassana meditation, which really helped manage the pain. I started to really read and study the Sutras, and I focused on the other limbs of Ashtanga practice. With these tools, which were nothing like what I had once enjoyed in my "traditional" asana practice, but were actually deeper in many ways, I learned I could manage the pain. My desire to continue on the spiritual path I'd started years earlier was aided by the gentle movements of the highly modified practice, along with the more intense meditation that Vipassana provided.

I did this for a year or so. It worked. Then, I went to a really great bodyworker, who, in just a few sessions, alleviated a great deal of the pain in my low back, allowing the spasming muscles there to relax and release. I very slowly started to do more Suryanamaskar in my practice, lengthening out the sequence of Primary series if it felt good. As soon as I felt my back starting to weaken or go into spasm, I would stop, do a gentle closing, and facilitate the slow but steady return to my former strength and flexibility. 

This really worked well. Pain management was easier, and while I still had a lot of pain in the mornings, I could do the practice. 

Then, I had the IUD removed, in December of 2009. 

Within a week of the device removal, the pain in my back was completely gone.  Within a month of removal, my body shed over 20lbs of water weight. Within six months, I was doing all of Primary and most of Second once more. People who hadn't seen me in a few months didn't recognize me. I felt young again. It was a miracle! 

No, it was the removal of the Mirena. I googled "Mirena back pain" after I had it removed, and was stunned by the sheer number of women who's experiences were similar to mine. 

Subsequently, I've had female students who have complained of back pain in their practice, and it's always one of the first things I ask: "Do you have an IUD inserted?" Upon removal of the IUD, their back pain and bloating went away, too.

Food for thought, IUD users! I know, they are convenient, I know, they are an easy and thought-free means of contraception. But, ease and convenience are definitely not worth the pain. Take it from me.