Wednesday, September 11, 2013

The swan twins and a LARC

A 4 bead mini GyneFix frameless copper IUD

Disclaimer: Some readers have asked me to provide medical advice. I am not a doctor.  This post does not represent and should not be considered individual medical advice.

Odette, Odile and GyneFix: Chris, our male Gyn, decided it’s best to take the swan twins off Beyaz and provide their contraceptive protection by a LARC (long acting reversible contraceptive) method, the GyneFix frameless copper IUD. An additional benefit is that it will eliminate the undesirable side effects of contraceptive hormones and with Yasmin, Yaz and Beyaz a possibly elevated potassium level. We have been closely monitoring the levels of contraceptive hormones in their bloodstreams since they joined us on Virgin Gorda and found them too low to be considered effective. And since they began their ballet training regimen which they will be on for at least the next year or two if they stay under my supervision it has dropped even lower. As returning readers may recall a 28 pill pack of Beyaz contains:

  • 24 pink tablets, each containing 3 mg drospirenone, 20 mcg ethinyl estradiol (EE) as and 0.451 mg levomefolate calcium (a metabolite of vitamin B) which lowers the risk of having rare neural tube defects in a pregnancy occurring during Beyaz use or shortly after stopping
  • 4 light orange tablets having no contraceptive value, each containing 0.451 mg levomefolate calcium
Low contraceptive hormone levels can usually be attributed to the woman not taking her pills correctly or taking dietary supplements or medicines that interfere with the hormones absorption into the bloodstream or vomiting within two hours after taking her pill.  The twins aren’t on interfering meds or dietary supplements, are taking their pills correctly and haven’t been vomiting so what’s left is a fast metabolism which caused the hormones to be purged from the bloodstream too quickly. I called Paul and asked if he knew anything about their high metabolic rates and he said the private school they attended in NYC mentioned that it was elevated, but their thyroids chemistry appeared to be within normal limits and that’s what their health records transferred to our clinic showed. Before someone asks I had the twins rechecked and they aren’t suffering from hyperthyroidism. They seem to have inexhaustible energy and put away quantities of food like football players w/o gaining any weight, an ability most women would kill for.

GyneFixed: The twins haven’t had any instances of breakthrough ovulation, that we know of, yet, but given their embarking on intensive sexual activity Chris feels the amounts of hormones in Beyaz are too low and with an abundance of caution he and I want them better protected w/o them taking larger amounts of hormones. We both think it better to have them use the mini-GyneFix, a frameless four button copper IUD, which is effective for at least three years. When properly inserted, the GyneFix frameless copper IUD offers several important advantages:

  • High efficacy (99%)
  • Efficacy does not decrease with time
  • Low expulsion rate (1%)
  • Reduced bleeding (4 bead GyneFix 200 Mini)
  • Reduced pain complaints
  • Long duration of action (3 to 5 years)
The twins were on their last pill periods so with the cervix naturally dilated a bit that was an ideal time to insert their IUDs. Chris inserted their mini-GyneFix IUDs Friday afternoon after their UNLV classes. They had taken 800 mg of Ibuprofen an hour before so after numbing them a bit he inserted Odette’s first as Odile held her hand. Then they swapped places. I went along for support, but they didn’t need me and would have done fine by themselves. I insisted on being there and I was glad I went to see how both handled the procedure. The worst part they said was when the anchoring knot was pushed into the muscle of the fundus.  They are fine and could have sex as soon as they felt able so they continued their pelvic training lessons on Saturday and they had a full weekend of energetic penetrative activity. More about that in a later post.

Coming off the pill: Taking the twins off Beyaz eliminated the likelihood of deep vein thrombosis (DVT) from the progestin drospirenone as well as avoiding the possibility of spiking potassium levels which could lead to heart problems. Having the twins begin cycling naturally again will allow them to take advantage of the burst of creativity that often accompanies a woman’s fertile interval and experience the full range of emotions due to cyclical hormonal swings.  Being off the pill should increase their vaginal secretions during arousal and they should experience a substantial increase in libido, not that they didn’t have healthy sex drives before. And by trimming off the GyneFix string as Cyndi and escorts who have IUDs as well as use cervical barriers do, they can safely wear a diaphragm or cap as flood insurance for upper reproductive tract protection during dive-sex.

The twins went on the pill at 14 to regulate their cycles and minimize their periods. Even when they switched to Beyaz they have had estrogen withdrawal headaches while taking their placebo pills and some breast pain as the estrogen from a new pack causes breast swelling both of which should disappear as their breasts decrease a bit in size. I don’t think that will be an issue since neither of the girls seems fixated on breast size and they are training to perfect their ballet bodies.  We don’t know for sure now that they are off hormones if their cycles will naturally stabilize, but we should know in about four cycles. In my case when I came off the pill it took three cycles for my cycle to return to normal. My period is relatively comfortable and I rather like the idea that bleeding is resetting my reproductive cycle to produce another egg and perhaps conceive and I hope to convince the twins to glory in their bleeding. My period is my secondary libidinal peak which is fairly common so perhaps they will have that positive experience as well.

Fellatrix class: Next week I’m going to begin the twins on a week of evening fellatio classes with some of the male escort candidates.  Not that that they had never given a blow-job, they just need practice in the nuances of the skill. Things like: massaging the frenulum with lips or tongue, collecting ejaculate in the mouth, forcing semen into his mouth during an afterglow kiss and how to force him to swallow it. It’s amazing how important it is to a man to have his partner swallow his seed, so it’s important to at least appear to enjoy swallowing regardless of the taste. Then there is the advanced course in deep-throating; how to manage the gag reflex, breathing during and how to keep semen from entering the lungs among other things


  1. You said those girls have supermetabolisms ("put away quantities of food like football players w/o gaining any weight" is what you said about them). I'm wondering what those girls are like size-wise (height/weight/body dimensions)? If I were to fathom a guess, they'd be 5-foot-6, between 100 and 115 and be 34A-20-32.

    1. Hi Eric,

      You are very close… Cyndi is 5’6” and the twins are 5’7”. The twins were 34C, but I expect that to drop to a B cup since they have come of the pill. Cyndi is 115 lbs and the twins are 120 which I expect will drop several pounds as the effects of the contraceptive hormones are flushed from their bodies.

  2. The current (fourth by some companies' count and fifth by another) generation of birth control pills have reduced the estradiol and which ever progestin substitute they are using. An unexpected consequence is unexpected pregnancies in heavier women. This indicates that either excess weight or rapid metabolism can result in lower hormone levels in the blood stream. Now that gyn's are sometimes considering weight in prescribing, perhaps they should also be considering other physical factors, such as an athletic lifestyle. We have also found an increase in the number of women who are not adjusting well to the newest pills. I still prescribe mostly third generation hormones resulting in both lower cost to the patient and side-stepping what may unintended consequences. Such as pregnancy. For over fifty years neither weight nor activity and metabolism levels have been considered. Suddenly, these are factors for the physician to consider.

    Coming right off the Beyaz (not my favorite) and having an IUD implanted may become an interesting exercise. It does take a few months for our bodies to adjust to the lack of artificial hormones and it takes many women four or more moths to adjust to an IUD. There may be some question from time to time which "insult" is causing adjustment problems. The switch is laudable but that is a lot of change at one time.

    I never thought of teaching a blow-job class although I have certainly had many questions from young women over the years regarding exactly the issues you will be addressing. Nice idea. If you are turning out real professional sex workers at the top end of the spectrum, these are absolutely required. I will not date a man or woman who does not go down during my period; certainly paying customers have an expectation of well honed oral skills. Basic to any woman's bag of tricks. I wonder how an advert in the local paper would be received: "Bi-sexual MD teaching how to suck! From unzipping his pants to swallowing his load all aspects will be covered. Bring a male friend for practice sessions."

  3. Hi, Jill,

    I used to offer my dates a workshop on tending the soft parts. I believe I titled it, "Your needs? Who cares about YOUR needs?" My new strategy is to let a sweet man root around till he gets it right, which I reinforce by digging a high heel into his cute butt. If I want him to change lanes, so to speak, I guide him by the ears. [I may have taken a bit of poetic license, but munch---root---heels---ears pretty much sums it up.]


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Powys , Wales, United Kingdom
I'm a classically trained dancer and SAB grad. A Dance Captain and go-to girl overseeing high-roller entertainment for a major casino/resort