I Saw Blood In The Toilet. I Never Expected A Common Drug Could Be The Cause.

When I saw the blood in the toilet bowl, I decided it was time to go to the emergency room.

I was doubled over in pain for the better part of three hours. It started out as par for the course: I was used to semi-regular stomach problems that left me stuck in the bathroom clutching my stomach. I assumed this was how my body behaved. I thought maybe I was dealing with irritable bowel syndrome, but I didn’t pursue a diagnosis after several doctors seemed unconcerned during my annual physical.

The blood, though. That’s new.

At the hospital, I was rushed to the examination room, where I was given fluids and blood tests. After a while, a doctor came in. He, like all before him, did not care. After the normal test results, he sent me on my way with a suggestion to see a specialist.

The pain eventually subsided, but the blood did not immediately. For days, I held my breath every time I went to the bathroom. My follow-up with a gastroenterologist wasn’t for two months (shout out to the health care system!), but something pissed me off, telling me I needed to go sooner. I am so thankful that I listened to that instinct.

I found someone who could see me, and while the bleeding had mostly subsided at that point, he scheduled a colonoscopy. The prep was miserable (if I never eat lemon jello again, it’s too soon), but the anxiety is even worse. On the day of my procedure, I remember feeling grateful for the anesthesia for taking me out of my head a little. When I woke up, my doctor delivered news I never expected: I had multiple ulcers in one part of my colon.

Several biopsy results and an MRI later, he came to a conclusion: My birth control pill, which I hadn’t taken since I was 17, was possibly the cause.

This diagnosis is essentially a best guess. Biopsies, bloodwork and MRIs ruled out conditions such as 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 I went to the ER.

Mostly, this issue occurs in elderly people. An ischemic event occurs when the blood supply to a particular part of the body is reduced. 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 on the combination pill, ie the birth control pill that contains estrogen. My doctor cannot guarantee that this is the cause with 100% certainty, because this condition has not been studied. What little research Existing on the subject suggests that the estrogen in the pill may be to blame, but this is “not clearly understood,” according to experts. Another theory my doctor had was that I had some kind of infection that caused the ulcers.

Regardless, he urged me to switch to another form of birth control as soon as possible, just to rule that out as a possible cause. Without oral contraceptives or a chronic infection causing the issue, my gut should heal and my blood flow should return to normal. I don’t have an official follow-up plan in place yet, but I imagine my gastro doctor will want to come back in the near future to make sure everything is healing as it should.

My doctor told me I was lucky that my trip to the ER didn’t reveal something more serious. The worst-case (and very rare) scenario is the risk of bowel 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 free. However, it felt paralyzed.

I took the pill about 15 years ago to help with acne and cramping during my periods. No one gave me any timing information beyond “take it at the same time every day.” Overall, I’m happy with it. My skin was cleansed. My periods have become more tolerable. I haven’t experienced any of the severe side effects that some of my friends have had over the years. I continued to take the same prescription until college and then when I moved to New York.

The pill is almost like a security blanket for me. I didn’t consider any other options after I left my first appointment; it never even occurred to me that there might be underlying health effects. Doctors never told me about them; I did not read the packages that came with the medicine, which were as thick as a book; and the benefits certainly outweigh the potential risks. Now, here I am over a decade later, and it gives me chills.

You’d think the choice to stay off the pill would be a relatively easy one ― after all, it’s my health at stake ― but it’s not. I struggled with the thought of hormonal acne taking over my face again, just in time for my wedding in May. I cried at the prospect of dealing with painful and unpredictable times. I dreaded the likely excruciating pain of inserting an IUD, which would have been my first choice alternative if I had decided to stick with contraceptives.

After a ton of deliberation and more urging from my gastro, I stopped taking the pill and switched to the hormonal IUD, which do not contain estrogen. I still support birth control in any form, including the pill. If I could, I would. I wish I knew more about the medicine I’ve been taking for 15 years. I wish there was more research on this for cases like mine, so that women can get a definitive diagnosis instead of a best guess. We can’t make informed decisions about our health care if our doctors feel in the dark as they try to help us.

Luckily, my gastro did as much investigation as possible until he found a logical and satisfactory explanation. I was surprised that he made the connection. So did my gynecologist, when I told him (and after reviewing my case, he agreed with his assessment). Other people won’t be as lucky to have a team of healthcare professionals spend time finding a solution — especially if there’s very little data to back it up. This is pure speculation, but I’d guess that if Viagra caused reduced blood flow to the colon, there would probably be more research on that.

It’s simple to advise people to be their own health advocates, but doing so requires a certain level of privilege: You have to have medical professionals believe you when you say something wrong. You need to talk to doctors who are willing to think outside the box. You need to have health care coverage to see specialists in the first place.

It’s been a month since I lost my birth control, and thankfully, I haven’t had any bleeding or stomach problems since my original incident (nor have I had any other side effects that I’m worried about ― please send good vibes to my skin). I don’t know if that was a coincidence or because we targeted the issue. I hope that my diagnosis is correct, and that changing my contraceptive is the solution to my problem.

Women’s health care ― up to research level ― is still nowhere near what it should be. This is especially true when it comes to birth control, but it happens in so many other areas as well. We need to speak up for our health, and we need to be willing to ask the tough questions ― sometimes repeatedly ― and push back as often as necessary until we feel heard. I’m lucky it didn’t cost me my life. One day, someone else was not so lucky.

Lindsay Holmes is the senior wellness and travel editor at HuffPost, where she oversees health and travel content for HuffPost Life. He was selected for a National Press Foundation mental health fellowship in 2016 and has moderated numerous panels on mental health. He is passionate about how the media can responsibly cover mental illness, and consults professional guidelines for reporting on suicide. He graduated with a degree in journalism from the University of Central Florida in Orlando, and is now based in New York.

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