I'll try to summarize as much as possible:
For over a decade my wife has been on the mini-pill (progesterone only) except for when she was pregnant or trying to get pregnant. She chose to go off the mini-pill a few months ago. Since then her menstrual cycle has increasingly gone haywire. At first it took over a month, then jumped around between 21 and 27 days, and then it went to less than two weeks, and for the past few weeks it seems like she's bleeding on and off every other day. Just when she thinks her period has stopped it kicks in again. Coinciding with all this are an increase in her migraines the past few months.
She spoke with her doctor about options. He isn't in favor of the standard pill, perhaps because when she used it 15 years ago it seemed to coincide with some increase in migraines, possibly from the estrogen. He worries that a copper IUD could make her periods worse when they're already a problem right now. He's fine with her going back on the mini pill or using the hormone IUD Mirena which essentially works the same as the mini pill.
My concern: I believe that there was a negative correlation between my wife using the mini-pill and her libido. I worry that the Mirena IUD option would do the same. Still, I'll support whatever is best for her health.
My wife now prefers to not use any BC at all (and place the burden of prevention on me), in part because she would like another baby. At the same time she recognizes that her cycle is out of whack and needs something to stabilize it.
I don't know if any of you have solutions to suggest, but I need a sounding board to figure out where to go from here. Of the options I know, it sounds like going back on the mini pill may be the best option, though I'm not thrilled about the side effects.