First: My Paragard IUD that I loved so well a year ago, I'm not so sure I love it. For the past about six months I've developed midcycle spotting that turned into midcycle bleeding and then there was no midcycle anymore. Past two months I've had near constant at least spotting, often actual bleeding, enough to need something not marked "light days." With peaks around periods but still, I never don't have to deal with it.
Second: My midwives said, okay, come in, we'll talk about other options plus we need to evaluate you for fibroids, because duh.
Third: My mom had fibroids. For which the treatment was total hysterectomy.
Fourth: I have been tapering my metformin dose. Maybe this bleeding is not related to the IUD or to any fibroids, but to hormones that are still messed up no matter how much I exercise or how well I eat. Maybe the PCOS is going to get me no matter what I do.
Fifth: After considering the previous, I very much hope it's the IUD. I would even settle for fibroids.
Sixth: I mean, I would happily raise my metformin dose again if I needed to. I don't have any side effects or long-term concerns about it but...there was something very rewarding about believing I'd healed something about myself. But, hey, maybe not. Maybe the trashed ovaries always win.