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Monday, March 12, 2012

532

IUDs, or A Detailed Guide to Long-Term Sperm Scarecrows

To nobody’s surprise, your Health Secretary received more curious inquiries about IUDs than any other topic. I hear you: an encounter with something that seems perfect for your vaginal needs, but what’s this nasty reputation. You ask yourself, “Is the bad stuff I’ve heard true? Could we work together — even in the long term?” If we’re still talking about IUDs, and I’m not sure we are, there are good answers to your questions. Let’s "I" and "U" "D"-scuss.

What is this thing?

The IUD is a T-shaped plastic or copper device that hangs out in your uterus as the most effective sperm scarecrow money can buy. It doesn’t protect against STIs. The two kinds available in the US are the Mirena and the ParaGard, and they both fit in my mouth.

Both provide extremely effective, immediately reversible birth control that is ready to go when you are and can’t be forgotten. Mirena is 0.3% more effective than female sterilization, even. Both can be left in for many years. The continuation rates are the highest for any reversible birth control, besides the implant. Unfortunately, you can only have one at a time. How to choose a favorite!?

Here’s a very comprehensive handout, but start with the biggest difference between the two: Mirena makes your periods lighter and ParaGard makes them heavier. By one year of Mirena, the progestin-containing hormonal one, average blood loss has decreased 90%, and 20% have no period at all. By 5 years, 60% don’t. There’s an initial period of increased pain and irregular bleeding — an average first month has more days with spotting/bleeding than without — but the amount of blood loss is already decreasing. If you’re the kind of person who couldn’t handle a lot of spotting, would get freaked out by not having a period, or abhors change, Mirena might be tough, especially at first. You might want a ParaGard, which doesn't affect how regular your cycle is; however, it does on average increase the heaviness of your period and the days you'll bleed for. If you already have a heavy/painful period, or you don't think you could tough one out, it's probably not for you. Fortunately, Teva, the manufacturer of ParaGard, does make other forms of highly effective non-hormonal birth control.

The other big diff is that Mirena has hormones and ParaGard doesn’t. You probably have some feelings about hormonal birth control, one way or another. There is progestin (Levonorgestrel) in Mirena, but not estrogen — if you’ve been told you shouldn’t take birth control pills, the estrogen is most likely the reason why. The amount of Levonorgestrel released is equivalent to about 1 mini-pill a week and goes direct delivery to your endometrial lining. This changes the type of side effects that occur. Local side effects, like bleeding changes, are much more common than system-wide side effects. Those side effects — headache, breast pain, acne — do still happen, but they happen less frequently and to a much smaller percentage of users (compared to users of the pill or the Depo shot, for instance, both of which have progesterone in them).

Bleeding and other side effects with either IUD are most significant in the first 3 months, but the main reason why people stop using their IUDs is frustration with the changes: bleeding too heavy/painful with ParaGard or bleeding too irregular or no period at all with Mirena. There’s most likely a way to make your bleeding better for you, so don’t tough it out! In addition to the “tincture of time,” reproductive health godbody Dr. Robert Hatcher suggests considering a few rounds of the pill. (By the way, he looks like this and literally all of his answers are this charming.) If it’s a pain issue, more likely with ParaGard, NSAIDs like Ibuprofen or Naproxen can really help, especially if you take them on a continuous schedule from the day before/of your period.

Cool, Can I Get One?

Most important question: do you have 6 centimeters of empty uterus? Whether or not you’ve had a kid before, you probably do: the percentage of nulliparous (no-baby-having) women age 15-25 without a uterus that size is only 30%. Next, let’s look at the WHO’s Medical Eligibility Criteria for Contraception, which provide clinical guidelines for selecting the safest contraceptive method based on risks of every imaginable type of medical issue. Risk of use is rated on a scale of 1 (no restriction) to 4 (no way). The IUD has very few hard “no”s. For you, an INFOGRAPHIC.

(Click here for a larger version.)

The average healthy 26-year-old in a long-term relationship who’s never had kids but did have one normal first-trimester abortion (“Lola”) scores a whopping risk rating of 2: benefits outweigh risks, method recommended for use. Here are general risk factors for chlamydia/gonorrhea, but you should make an individual assessment with your provider. The construction paper may have already given it away, but the above is not very comprehensive. I recommend the brave/curious peruse this summary or the full guidelines.

So, looks like IUDs are a safe option for most women! So why did you hear ... anything other than that? The origination of the IUD’s bad rep in America was when one of the O.G. IUDs called the Dalkon Shield caused infertility and sepsis in great numbers with its horrible, Facehugger-from-Alien “clawlike appendages.” There have been great articles recently covering the historical and scientific aspects of what happened next, but the sum total is that fear, misinformation, and underutilization have been perpetuating each other ever since.

Depending on what graph comparing IUD use by country you’re looking at, our rate of 5.5% is either “very low” or “dead last,” even though the usage rate almost doubled between 2002 and 2008. This is to say: if you want an IUD, you might still have to safari into medical self-advocacy. A common species you’ll find there is a well-meaning clinician who thinks they’re preventing you from harm: you can tell them by their suggestion that you first try another “less drastic” method, like the pill. They’re most likely just under-informed, so you can go so far as to furnish research like ACOG’s recommendation that IUDs be offered to most women as first-line contraception. Or share this thought experiment!

“You’re sick and there’s two treatments: a device that sets up in minutes and works for years and a pill that’s only as effective as the device if you take at same time every day forever, which is actually so difficult that 31% of users fail at in the first 6 months. Wouldn't you be like, ‘Fucking give me the easy thing!’ (put on sunglasses) So why is preventing pregnancy so different that you wouldn’t treat with the most effective, least likely to fail treatment first?” (drive away in red convertible)

Every provider has a different risk tolerance. It’s possible that the reason they don’t want to insert a Mirena is because they’ve never done it for someone without kids before. If someone says they won’t insert an IUD for you, they should able to tell you where they’re coming from and give you suggestions about other options to consider. But also be on the lookout for clinicians who make their recommendations against scientific evidence to rationalize their own moral beliefs. You’ll know this species when any questioning about why the IUD can’t happen for you is dismissed with a moral judgment, like “you have too much sex” or “because you’re not married.” Say thank you, disarm them with one of those hoods you put on birds to make them sleep, and switch to someone else in their practice. Or another practice entirely!

Fun-ding

 

I tried. IUDs are paid for up front: what you pay = the price of the device + the price of the medical care. CostHelper says $10-$160 with insurance and $210-800 without. It is the cheapest option in the long term, but the ability to think about cost in the long term is out of reach for most people. More succinctly, fuck-all it gives you if you don’t have that kind of money up front, and many people don’t, including myself. Shout out Republican Congresspeople, current sponsors of this paragraph and a fucked-up world where people must financially justify if they can control their own bodies! Thinking of You each time I have a conversation with a patient unable to afford contraception: “Let’s work this out — what’s not being forced to become a mother worth to you? Up front? Monthly?”

Strategies! Insurance: call the number on your membership card and ask if you’re covered for CPT-58300 (IUD insertion) and CPT-58301 (IUD removal). Then, ask if you’re covered for the actual Mirena (CPT J7302) or ParaGard (CPT J7300) device. If they say no, ask if the device is covered under your pharmacy benefits or if you can use a flexible spending plan.

No device coverage or no insurance: people whose income qualifies can get the Mirena for free through the ARCH Foundation and the ParaGard through PPAP. There are also payment plans available from the manufacturer. Mirena’s has 3 payment options, with the lowest payment $35 month/2 years, and ParaGard’s payment plan is $40 month/1 year. To try to save money on the visit cost, check out your local Planned Parenthood or public health clinic: many of these have in-house programs that subsidize IUDs.

How Go Insertion?

All this chatter and the damn thing takes like 5 minutes to put in. Okay! First, we make sure you’re not pregnant. Since there’s some lead time before a pregnancy test turns positive, you’ll probably be asked to ensure you’re not pregnant by not having sex for 2-3 weeks before the test or by being on a reliable birth control method. You might also get STI tested, and your uterus will be measured for sufficient size and shape. This is done in different ways: ultrasound imaging, a pelvic exam, or by inserting a “uterine sound” — thin rod with a ruler on it — through the cervical os (cervix = donut, os = donut hole).

You may have noted that pain during insertion seems to differ wildly, especially for internet commenters. Some people sense nothing but a butterfly wing’s momentary twinge while others discover an extended sensation indistinguishable in severity from being on fire. Good news: a large analysis of multiple studies of insertion-pain intervention found that no method works better than another. Bad news: uh, that’s because none of them worked. Until the evidence comes through, go with your gut and what your provider suggests. A hot water bottle is a good look afterward.

Who feels more pain? Oh, who knows, Edith found me at a bar! Jokes, we met in yoga class. Double jokes! Edith isn’t real. You’re more likely to feel pain at insertion if you’re nulliparous. Even then, it’s not that bad: in a study of only nulliparous patients, 9% had no pain, 72% had moderate, and 17% had severe. 72% reported they found the insertion “easy.” Other factors found to predict more pain were painful periods, higher level of education, and longer time since last pregnancy. Oh, and you’ll have more pain if you think you’re going to have more pain: “[Anticipated pain] was slightly higher than overall perceived pain ... Studies of other gynecologic procedures also show anticipated pain scores to exceed actual scores." What this says is: if you can relax, that will help. And if you can’t, it’s okay, because it’s still not going to be as bad as you thought it would be.

Another evidence-free zone is when in your cycle you should schedule your insertion: we know it’s definitely not necessary to be on your period, and there’s conflicting studies as to whether it’s even helpful to be. The latest recommendation is to be mid-cycle, but that might change. One thing that might happen is that if your cervix proves difficult to maneuver, coming back during Shark Week is one of the methods they may try, along with softening your cervix with misoprostol.

IUD insertion is mostly similar to what you’ve already done for your annuals. You’re put in the stirrups and a speculum is inserted. Sometimes, the cervix is cleaned by a q-tip. The path for the IUD is straightened out by holding your cervix with a pair of lady-tongs called tenaculum, which you should never google pictures of because they look way worse than they actually are, I swear to you. The os is dilated if needed. The IUD itself comes in a long straw that functions as a tiny intrauterine cannon, as seen with the ParaGard below:

Please don’t be alarmed if your gynecologist has less-whimsical helpers! We thread the straw into the uterus through the cervical os, withdraw the tube, and bam. You’re done. Your provider might cut the strings or leave them as-is: whichever happens, ask how long they are so you have a baseline for when you check them yourself.

Because of the 1% risk of a vasovagal response, your provider might have you lie down for a while before you leave, even if you feel fine. The same nerve that regulates your heartbeat runs through your cervix, so  putting something through the cervix can accidentally trigger the nerve. If this reaction does happen, your blood pressure/heart rate will drop, causing a brief spell of symptoms like fainting, dizziness, nausea, and clamminess. To summarize, while a vasovagal response is one of the scariest harmless things that can happen to a human, it is also the most tangibly scientific evidence of the heart/vagina connection we have today. I thank you.

Now You’ve Done It

I recommend spending the time between insertion and resuming sexual activity contemplating being one step closer to a cyborg and perusing this excellent patient education from Bedsider. You’ll see there’s very little you need to do to take care of an IUD over time. As long as it’s in there, your IUD is going to be TCB. The most you'll probably think about it is in responding to those around you who are horrified by your decision. “The complications!” they’ll say. If you hear something and it’s not here or in any patient education you received, perhaps it can be found exhaustive document on IUD myths. Here’s the gist:

1. Perforation: 1 out of every 770-1600 insertions. This sounds scary as hell, i.e., but it’s rarely dangerous. The uterus will most likely heal itself: think about how often and well people heal their entire uterus being cut open for a C-section. There is conflicting evidence that perforation can happen at any time other than insertion: more likely, it’s just not noticed immediately. Even strong uterine contractions — like with a very heavy period — won’t make it "go further" into your uterus, although they can increase the risk of it coming out. And that’s called...

2. Expulsion: 2-10% in the first year. Specifically, the Mirena has a rate of 2.3% if you got it only for pregnancy prevention and 10-13% if you got it for a medical reason, such asendometriosis. The evidence of nulliparity (no baby) increasing your risk of expulsion is dicey; stronger risk factors are being under 20, insertion during your period, or having heavy/painful ones. If you get another IUD, there is a 30% chance of having another expulsion: most recommend closer monitoring the second time around.

3. Infection: Having an IUD straight up doesn’t raise the risk of pelvic infections: what does raise the risk is pre-existing gonorrhea or chlamydia at insertion. This is why the rate of pelvic inflammatory disease (PID) in women with IUDs drops to the same as women without after 20 days of use. Even if you do have chlamydia or gonorrhea at the time of insertion, the absolute risk of PID is still so low that it’s considered reasonable to test you and insert the IUD before the results come back. A single episode of PID will cause tubal damage infertility in about 10% of cases. (The Mirena might actually prevent pelvic infections, a possibility that IUD expert Dr. David Grimes describes as “tantalizing.” I am not yet where you are, Dr. Grimes, but I hope to get there one day.)

4. Ectopic Pregnancy: “0–0.5 per 1,000 ... compared with a rate of 3.25 – 5.25 per 1,000 among women who do not use contraception." So your risk of ectopic pregnancy is lower! However, if a pregnancy does occur with the IUD in place, it’s proportionately much more likely to be ectopic.

5. Infertility: Tricks, not an IUD complication! Having a history of chlamydia, not IUD use, is correlated with infertility. Chlamydia does the crime, the IUD does the time AGAIN.

Similar to how side effects work, complication rates are highest at the beginning and then decline, but mind a parable? You’re too kind. You get Mirena and notice something like a mild yeast infection that never quite goes away. You go to your provider and they say: there’s very little chance that the IUD could be causing it. Somehow, after they say this, your discharge magically goes away forever!!!!!!

If you think your IUD is causing something to happen to your body that you don’t like, look into it with your provider. There’s a good chance that no matter what the cause, it can be managed. Then, success all around! You keep the birth control you wanted AND you’re happy on it. But you are the only person who can decide if a side effect is tolerable, how long is too long to have it, how many times you’ll try treating it or whether you’ll try treating it at all. If you want it pulled, that’s exactly what you should have.

& Goodbye

 

Can’t believe we covered it all. Guys, I feel amazing — and whoever brought the guitar, thank you! I love the way “Time of Your Life” sounds on an acoustic, especially when we’re all singing along.

Only one thing left: saying goodbye. IUD removal is usually very quick: we just grab on to the strings and (gently) pull. If you’re getting it taken out because you want to get pregnant, both IUDs have an immediate return to fertility after removal — 54% get pregnant within the first 3 months and 80% within a year, so congratulations may shortly be in order. I leave you with a personal photo of my top bro Alison’s enviable gyno gameface as she pulls out my ParaGard to replace it with half of a best friend necklace:

References
Big time: Contraceptive Technology 19th edition / Managing Contraception
ACOG Practice Bulletins: Long-Acting Reversible Contraception: Implants and Intrauterine Devices, Intrauterine Device and Adolescents
A great breakdown of actual PID risk
http://www.who.int/reproductivehealth/publications/family_planning/9789241563888/en/index.html
http://www.uptodate.com/contents/management-of-problems-related-to-intrauterine-contraception#H2
http://www.medscape.com/viewarticle/575550
http://www.ncbi.nlm.nih.gov/pubmed/21691183
http://www.ncbi.nlm.nih.gov/pubmed/21872240
http://www.ncbi.nlm.nih.gov/pubmed/21668037
http://www.ncbi.nlm.nih.gov/pubmed/19442775
http://www.mirena-us.com/hcp/ordering_and_reimbursement/how_to_order.jsp
http://pds7.egloos.com/pds/200710/05/64/pid.pdf
http://www.uptodate.com/contents/overview-of-intrauterine-contraception

Further Reading
http://maybetheiud.org
http://bedsider.org
http://www.reproductiveaccess.org/contraception/iud_aftercare.htm

Some more on funding: http://www.communityobgyn.com/uploads/files/misc_info_packet.pdf
ParaGard patient info: http://www.contracept.org/docs/paraguard-patients.pdf
Mirena patient info: http://berlex.bayerhealthcare.com/html/products/pi/Mirena_PI.pdf
If you want an insertion video, here’s one.

Lola Pellegrino is a registered nurse with a tumblr, and is well on her way to becoming Dr. Queer, Medicine Woman. Do you have a health question for her?



532 Comments / Post A Comment

atipofthehat

I did not know these were indicated for oral sex until I saw the illustration.

SarahP

@atipofthehat I am madly in love with my IUD, but that picture appalled me. I would never tongue one.

atipofthehat

@SarahP

They look like little anchors for the man in the boat.

Danzig!

@SarahP Copper in the mouth! Ughhh

SarahP

@Danzig! And how safe is it to lick a hormone-releasing IUD? That'd better be a prop Mirena!

Danzig!

@SarahP Mirena treated a very serious matter too flippantly and now she can never have the mouth pregnancy she always dreamed of.

Aaand I'm gonna go get that mental image out of my mind somehow

SarahP

@Danzig! You have ruined my brain.

sox
sox

@SarahP I have wondered this about users of the ring. Lola, are things...more hormonal down there when there is a ring emitting hormones so close by?

angelinha

A note on cost: I have Blue Cross and mine was 100% covered - I paid $0 total, not even a co-pay. So definitely call your insurer and ask. I would have had to pay for the device itself if I hadn't had it ordered and inserted at the same visit (like, if they gave me the IUD and I took it home, then brought it back to be inserted? I don't know).

Megasus

@angelinha I have Ontario Blue Cross and they do not cover it, I don't think. Pretty sure it only covers BC in pill form.

jagosaurus

@angelinha I was just going to say the same. My insurer paid 100%, but had I gotten my IUD while working for my previous employer, I'd probably have gotten almost no coverage.

nonvolleyball

@angelinha I have Blue Cross as well (in the USA), & my only expense for the Paragard was a $10 copay for the office visit/insertion.

...as opposed to United, my parents' old insurance, which only covered the Pill as an acne/cramps/etc. treatment, not as contraception. fortunately my gyno was able to write the scrip accordingly, but damn: you think a 17-year-old girl is better off getting pregnant than having acne or whatever? because that's messed up.

hellonheels

@angelinha I have Kaiser Permanente, and mine was totally covered except for the $20 office visit copay.

limberliz

@angelinha I also have Blue Cross and not only was my Mirena completely covered, but so was my abortion a month earlier. My company is employee owned and good health insurance is very much expected. This is now the third Blue Cross plan I've been on in the last five years and probably the best. (BCBS of ME, AL and now MA) I live in California and finding a provider for IUD insertion wasn't a big deal. My ob/gyn nurse practioner was happy to do it and had both available on appointment day if I changed my mind.

tideturns

@angelinha i have united healthcare and the paraguard IUD with my insurance was more expensive than going to Planned Parenthood and not having insurance. ($1100 united healthcare and $750 at planned parenthood)

LeafySeaDragon

i HATED my iud, it was pretty much 2 years of incredibly horrible cramps and spotting, and i developed scarring/irritation where the wires rubbed on my cervix. HATED IT!!!! i finally got fed up and got it out after passing out from the pain in a big box store.

upside: did not get pregnant. also was a breeze for removal. all my friends had thiers with little or no issues. me, i got lucky. *it was totally covered my my healthcare, i paid nothing. i had the tiny plastic mirena with hormones, it was white

ladies: talk to yo man (if you're in a ltr) about getting a vasectomy. BEST EVER *this cost about $150

insouciantlover

@LeafySeaDragon Can you clarify which kind of IUD that you got?

Sarah Lapré Yeatman@facebook

@LeafySeaDragon I had the same experience. Mine ended up lodged in my uterine wall (according to the OB/GYN who removed it, this was most likely due to it being inserted "too soon" after my last child was born; apparently my uterus was not back to normal size at time of insertion. They put me under general anesthesia to remove it). It was in place for two years before I finally had it removed.
Having said that, I know my experience was not the norm, (oh and my husband ended up with a vasectomy, too-problem solved).

parallel-lines

@LeafySeaDragon I hate my IUD. HATE HATE HATE. It took me years (uh, five years) to find a gyn who would agree to do one in the first place since I don't have kids (still a common myth, even in NYC). Got the non-hormonal, was very lucky that it was covered in full by my insurance (suck it, Limbaugh) and it was the worst doctor's appointment of my life. Like, I almost fainted, couldn't walk and was in so much pain I cried for a day. Then came the seven+ day long periods with cramping so intense it'd ocasionally knock me out of my chair into the fetal position, not to mention those suckers are a super plus tampon every hour heavy. And the painful sex (my cervix cannot tolerate being touched). It also sucks in weird ways I never thought about before: need an MRI for an injury? Hope you like feeling your IUD moving inside of you (if it starts "burning" so much you can't take it they'll agree to stop the MRI but will be jerks about it). I got a weird band of fat around my lower abdomen (where there's never been fat before).

Now I have to get the damn thing out and I'm scared and sad that something I waited years for didn't even work for one year.

Your milage, of course, may vary.

LeafySeaDragon

@parallel-lines it was immiediate relief to get it removed! dooo eeetttt!!!!

i don't mean to hate on iud's so hard, but i only heard positives before i got mine so i was a bit shocked when it turned out badly. best be informed!

parallel-lines

@LeafySeaDragon Me too - they seem so great for some people but not me. In fact, I can feel that little fucker RIGHT NOW. I feel it all the time. I even did my IUD diva livejournal research but man oh man I wasn't prepared for this shit.

DrFeelGood

@parallel-lines I am glad that someone is with me. I have a lot of friends who got it, but I have had pretty much a horrible experience. Yes, it is like being on a medical safari. No doc really knows what to do with me. I was having HORRIBLE cramps/pain, and finally got a transvaginal ultrasound because I convinced myself I had an ovarian cyst. I did not have a cyst, but I have partial implantation of my IUD in my uterine wall. I am currently waiting to get it removed and the doctors were pretty horrible, like, oh I guess you can get it out, if you want? I finally went to a gyno surgeon and she was so perplexed like UMM why would they advise you to leave it in.

Basically the man who is inventing male BC should receive a fucking Nobel Prize if it ends up working out.

So long story short - should I get another IUD? I went from pretty normal periods to long cramps, blood, etc, which even though I wasn't on hormones, decreased my sex drive a lot. I am waiting to set up the removal appointment. If it is too far imbedded in my uterine wall I will have to have it removed in the OR :(. My other (non-hormonal) option is a diaphragm, which I am seriously considering at this point.

little fish

@DrFeelGood Have you looked at the Implanon implant? My gyno was unable to get a Mirena IUD in for me (long, awful story that involved me fainting in the waiting room and lots of concerned pregnant ladies), so I got an Implanon. Small flexible rod inserted into my upper arm that gives me BC protection for three years, easily removed to be switched out for a new one or totally removed, and I get a normal period maybe every four months? If you a non-hormonal option, it won't work for you, but I would seriously consider it if you could take a progestin-only method.

255
255

@LeafySeaDragon @parallel-lines Wait wait wait--NOW I AM TERRIFIED. I am getting a Paraguard next Wednesday after reading all the raves, and my recently acquired hate of condoms (I'm in a monogamous relationship) and I had never heard of any of this. I thought it doesn't have any system-wide side effects?? I am not on any BC right now other than condoms bc I hate BC side effects. BUT WOW reduced sex drive? That is why I gave up BC! Abdominal fat? Heavy cramping and heavy periods for a year? PAINFUL SEX? Consider myself freaked out. Most people say they feel the same except for heavier periods but the rest of this I could not deal with. I guess i could just get it removed if it happens, but please tell me how much int he minority you are.

LeafySeaDragon

@scazza sofija i know lots of other ladies with them, and they loved them, aside from the initial insertion pain. it didn't work FOR ME though. it's def worth a try! looking back i wish i hadn't kept mien so long when i knew it wasn't working.

The Lady of Shalott

Yay, thank you for this!!! I love you!

Ah wait! Sometimes, the cervix is cleaned by a q-tip

Does...the cervix need to be cleaned? Part of me loves the image of a gynecologist going over the cervix and carefully mopping it up, but part of me is like....oh god what are they cleaning OFF it?

Lola P.

@The Lady of Shalott thank you! i love you too!

nope, although it's harmless, no evidence supporting any need to be cleaned that i could find, but many do it anyway. this was an unfortunate theme for writing this article. vagina doctors, get yo evidence base right!

The Lady of Shalott

@Lola McClure Oh thank goodness! I was slightly freaked out for a second there.

Thanks again for doing this! You are awesome!

parallel-lines

@The Lady of Shalott I usually clean my cervix with a power washer and have a team of men give it a good scrubbing before the second power washer spray down. Hairdryer and coat of wax to set.

Mingus_Thurber

@parallel-lines Why go through all that? I just pop mine into the top rack of the dishwasher.

parallel-lines

@Mingus_Thurber Well, I mean--it does beat the old timey method of taking it to a river and beating it on a rock.

Ophelia

@parallel-lines Or *shudder* scrubbing it on a washing board.

parallel-lines

@Ophelia Well, there's always bleach and lots of it! Maybe a brillo if you really need some extra power.

Ophelia

@parallel-lines OxyClean! Although <3 u, bleachie, of course.

fondue with cheddar

@Ophelia I like to soak mine in a cup of white vinegar.

Message from your cervix

@The Lady of Shalott Trust me, that's the best way to clean your cervix!

Xanthophyllippa

@jen325 I use Efferdent. Cleans the cervix AND the coffee cup!

Kingsle

@parallel-lines I think we need to consult A Clean Person.

sinki

@jen325 I have actually had my cervix cleaned with vinegar! Vinegar solution shows up abnormal cells during a colposcopy. Or as my doctor put it: "Get for salad dressing, great for a healthy cervix." Nawww.

fondue with cheddar

@Xanthophyllippa That's a great idea! I HATE when my cervix gets those nasty yellow stains.

fondue with cheddar

@sinki <3 U VINEGIE!

Bitterblue

@jen325 I like to do the "vagina volcano". I stand on my head, and use a funnel to pour in baking soda and then vinegar. FWHOOSH! Clean as a whistle.

fondue with cheddar

@Bitterblue The eruption of Mount Vagsuvius!

How weird is it that actually I kind of want to try that? Just to see what it feels/looks like? I think it would be Interesting. I probably won't, though.

Xanthophyllippa

@Bitterblue Also a great experiment for the kids' science fair!

area@twitter

Thank you, this is PERFECT. ::standing, applauding::

hot dog princess

Before I clicked on that link about Tevas, I seriously got excited thinking that there were other forms of highly effective non hormonal birth control I didn't know about for a second. DREAMING THE IMPOSSIBLE DREAM

nonvolleyball

@hot dog princess haha, I did the same. & then I laughed. :)

NeverOddOrEven

@hot dog princess It took me a second. I had to go back and look again before it clicked.

Clearly that latte I shouldn't splurge on is in order.

Tragically Ludicrous

@hot dog princess I was mostly hoping that birth control was like, a side division of the shoe company. Because how great would that be?

Lola P.

@Tragically Ludicrous IT IS! same exact company. THE WORLD IS GREAT

breccia

Awesome! I've heard that the "hormonal" moody/etc side effects of an IUD are different from what you get on the pill. Can anyone elaborate?

roadtrips

@breccia I have the Paraguard, and my mood side effects are very similar to those I would feel pre-pill - basically, your standard non-hormonally mediated emotions. I do have friends who have IUDs because being on the pill made their moods fluctuate wildly in the weeks/days surrounding their period.

breccia

@roadtrips What about your sex drive? Mine got all shy and quiet and went and sat in a corner by herself when I started on the pill. Half the reason I'd like an IUD is to get rid of all the phony emotions that go with hormones my body doesn't normally produce.

roadtrips

@breccia Yes! I mentioned down thread that I've felt more in touch with my reproductive system, and my body in general. My sex drive now follows a pretty standard pattern based on where I am in my cycle, and before I removed hormones from the equation I definitely didn't feel as in touch.

Mingus_Thurber

@breccia I've been on two pills (Ortho-Cyclen and ON 1-35) and now have a Mirena. With Ortho-Cyclen, I had 'orrible breast swelling and tenderness, water weight gain, very heavy-though-painless periods, and a HUGE reduction in premenstrual dysphoric disorder. With 1-35, I had none of the above except the reduction in mood swings: in other words, it was the perfect pill for me.

The Mirena has continued all the good stuff about the high-progestenic-action pill (ON 1-35) with the added benefit of no periods at all. (Matter of fact, thinking back, I think I've had one period since, uh. . . 1997?) I do have a bit more emotional lability now prior to my period, but I attribute that more to work stress and being 42 than I do the hormones or lack thereof.

For what it's worth, *in my experience only,* women who are on monophasic pills (one steady dose of hormones throughout the month) have less emotional falderal around their periods than those on triphasic pills like Ortho TriCyclen.

insouciantlover

@breccia I have the Mirena (the hormonal one) and the hormones are NOTHING like what I experienced with the pill or Nuva Ring. The hormones from both of those made me feel really emotionally unstable and my period would just forge on through whenever it liked, anyway, which generally meant a ton of spotting.

The low doses of the Mirena do not effect me in an even remotely similar way.

realtalk

@breccia when I was trying to decide between paragard (nonhormonal) and mirena (hormonal) this is one of the questions I asked. because mirena is roughly the equivalent of 1 low-dose progestin only pill, the mood side effects are smaller than estrogen-containing BCP, but I was too freaked out by my previous hormonal birth control experiences, so I went with paragard. If you historically have tolerated hormonal birth control just fine, mirena is probably great for you, but if you like the idea of not being on hormones, and your periods aren't super heavy already, then paragard can be the best!!!

Just a Day@twitter

@breccia I went from NuvaRing to an IUD (Mirena) for my sex drive- I was at one point ALL ABOUT THE SEX and then, after being on a hormonal BC for a while I was... no longer all about the sex. My gyno did mention that usually lady sex drive is more affected by stress, but I will say, within two months my sex drive has bounced back to what it was (as in, some days I still don't feel in the mood but it's not this huge struggle to get in the mood that it used to be). If this is a concern for you go chat about it! The hormones in the Mirena apparently don't really 'travel' past the uterine area so you aren't going to have the huge systematic effects that you would with a pill, which has had a big change for me.

Ophelia

@Just a Day@twitter That's really good to know, because it's one of the reasons I went off the pill - I suppose the much lower dose in Mirena is what keeps one from being so affected, which sounds great! If I wasn't pondering having kids in the near future, I'd probably go get one asap.

katerrific

@breccia Having been on the pill for 10 years before I tried Paragard, I was amazed at the difference in my sex drive. Like, I didn't realize how low it actually was until I went off the pill, and then it was like, "Oh! My body is actually physically responding to touch! How novel!"

fondue with cheddar

@Mingus_Thurber et al: Thanks for this thread! I was one of the writers-in to Lola about IUDs because I've been thinking about getting one, and hormone craziness like what I had when I was on the pill was my primary concern about the Mirena.

BusyBrie

Thank you, thank you, thank you for your fabulously informative column on the much-maligned IUD! I have recommended them to every birth-control-pill-popping woman I know, and now I have a great one-stop information shop to point them to. I got Mirena when I was 28 and wanted to get off the Ortho so that my husband and I could just pop that IUD out as soon as we wanted to start trying for babies. It was 100% covered by my insurance, totally pain-free (other than 3 seconds of hell during insertion), and totally stopped my periods for the entire time it was in there. HALLELUJAH! Mirena also kept me baby-free and our sexy times worry-free - and when I finally had her taken out I seriously didn't feel a THING. Totally quick and easy, and the greatest bc choice I have ever made. Tell your friends and loved ones! IUDs are where it's AT!

LRMG

Personal anecdote time: I have a paraguard and after a year my period flow and cramps normaled out. It still takes seven days (it always did regardless of bc method) but the flow is light.

Also, I personally recommend my IUD to any and all. I am possibly like one of those fake ladies in bc commercials who are telling their friends about how great their bc/tampons/prescription meds are. Paraguard all the way!!

Are They Biting Ducks?

@LRMG Me too! I'm seriously a ridiculous Paraguard evangelist - "Oh, you're having a bad day? Have you tried PARAGUARD?"

realtalk

@LRMG aaaahhhh samesies!!! <3 u paragardie

grizzle_bees

@LRMG bahaha. This happened to me the other day. I was raving about my Paraguard to my friends and one of them was like, "Wait, are we in a commercial right now?" To which I replied, "Yes! Now let us laugh and eat salad."

beeline96

@Are They Biting Ducks? Paragard Evangelist: much less of a mouthful than "token IUD-touting friend." I'm taking this. Thanks!

LilyMarlene

@shart_attack This entire thread, but especially Laughing and Eating Salad with Paragard. Hahahahaha. *snort* Bahahaha.

fondue with cheddar

@LilyMarlene Laughing and Eating Salad with ParaGard while Struggling to Drink Water.

vivian darkbloom

I wish this had been around a few years ago when I had so many questions! I have PCOS so I needed something to make me shed my lining to prevent a pre-cancerous bedding in my girlguts because I would go all year with no period. I also have migraines with aura meaning no doctor will give me birth controls because of increased stroke risk. Despite several doctors telling me that my either my uterus was too small for an IUD or that I couldn't have one because someday I might want children, finally it was decided that it was my best option given the PCOS + migraine situation. I was given a valium or something to take beforehand to chill me out and also took the recommended amount of Advil beforehand. Let me tell you guys, I'm no pussy. I have chronic migraines and have had piercings and once a doctor told me I had the worst case of strep throat he'd ever seen and I thought I just had a cold. I'm a tough lady. When I got that damn IUD I screamed and cussed like I was giving birth. I almost passed out and it hurt worse than I thought it ever could. Maybe the previous doctors that told me my tiny uterus couldn't handle one well were right because holy jesus. I was embarrassed at the obscenities that spewed from my mouth. I was in bed the rest of the day and aching for the next but it got better. ALSO, I think my hormones or something freaked out because I didn't want to talk to anyone and cried every day for about a week shortly after. I'm not sure what's up with that. Since then I've had no problems, but I'm honestly terrified of getting another one in a couple of years because the first one hurt SO BAD. And mine was 100% paid for by insurance.

roadtrips

@vivian darkbloom I also had a total horror show of an insertion. I have never. felt. pain. like that in my entire life - either before or since. Just reading the words "uterine sound" made my insides curl up inside of me and throw the covers over their heads. I also have longer/heavier periods and more severe cramps (although nothing that some ibuprofen can't help with). That said, I don't at all regret my choice - I feel like the trade off (for me) for having hormone free birth control (I have Paraguard), that my insurance covered, that I can't forget, that won't fail, and which is totally reversible is 100% worth any and all side effects. I have been totally satisfied with my IUD so far, and in fact it has made me feel much more aware of what's going on with my reproductive system. Sorry - I meant for that to be a commiseration of your experience and it turned into a little pro-IUD rant, but still. My advice if anyone else is considering - keep thinking about the long term benefits!

vivian darkbloom

@roadtrips I'm not glad you had a bad insertion too, but I AM glad I'm not the only one! I have several friends that said they barely felt it and I do. not. understand. It was definitely worth the hellacious pain and week of crying in the end, so I'm still an advocate for getting IUDs, but damn, y'all. I was wondering if my gyno was some kind of weirdo that liked torturing uteruses. (Side note, he told me my ovaries looked like "chocolate chip cookies" due to all the cysts, so I still think he's a weirdo. Why that comparison? Why???)

roadtrips

@vivian darkbloom :/ They actually didn't insert mine correctly the first time and had to do it AGAIN. ALL OF IT. Oh my god it was awful. And then I biked to work afterward, because I don't know. Word of suggestion to anyone considering the IUD: take the rest of the day and the next day off!

SarahP

@roadtrips Not to everyone, though! I had mine done early in the day and went on to a full day of work. I was fine! (I wouldn't've biked, though, how brave!)

Lola P.

@vivian darkbloom yeah, you are the 17%! i'm sorry you had that experience but i'm glad you're happy now. TWO EMOTIONS.

as for your ovaries, whoa, never heard of polycystic ovaries being described as chocolate chip cookies--although the "classic presentation" is called the pearl string sign, or "a string of black pearls on a white neck." !?!?!

vivian darkbloom

@Lola McClure So many creepy descriptions of ovaries! But I'm glad the medical community is amusing themselves and staying creative. (P.S. Thank you so much for this article! I'm looking forward to future ones!)

Lola P.

@vivian darkbloom you are so welcome! yeah, imaging is deathly boring, gotta stay occupied somehow. may i acquaint you with the puppy sign, which indicates your carotid artery is busting open?

LydiaBennett

@vivian darkbloom I have PCOS too and have been considering an IUD. Are you on ParaGuard? I assume yes because I feel like having Mirena lighten your/my period would be a no-no, re: cancer? Definitely something to consider...

amelia!

@vivian darkbloom Until I read this I honestly didn't think it was okay to holler at the doctor's office (um, forreal), but knowing that other people do it makes me wish I could re-do my insertion so instead of quietly whimpering while all the tears and sweat in the world ran down my face and I tried to count all the little dots in the dropped-ceiling tiles to keep myself from puking/passing out (vasovagal nerve WHAT), I could just say FUUUUUUUCK. (Just kidding though, I am not interested in reliving that experience even with permission to curse.)

vivian darkbloom

@Amelia Allard@facebook I was convinced everyone would think I was giving birth. I asked my friend if she could hear me screaming in the lobby. She said no but I don't believe her. The doctor didn't act like it was weird or anything. He just kept saying reassuring things and then told me I could lay there as long as I needed to, so I assume screaming is acceptable when things are being inserted into your organs. I just wonder if that means it'll hurt as bad coming out?

amelia!

@vivian darkbloom I don't know! I think (at least for me) it was the sound that hurt the most. After I had the insertion I googled "uterine sound" and then died a thousand times. The IUD itself is much smaller and less "a terrifying metal rod" so I think when they pull it out it's far easier.

That being said, I am so ready to take a page from your book and holler my head off.

SarahP

@vivian darkbloom Almost all the removal stories I have heard make it sound like a breeze. Brief cramp when they pull it out, maybe a little cramping after, but nothing compared to insertion.

twocats

I love my IUD! I had bad cramps before the IUD and still have them, but the ease of it, no hormones (I have Para Guard), and low on-going cost more than makes up for it. I highly recommend!

As a side note, I had a hell of a time getting one from my university and even Planned Parenthood while I was in college, as all of the doctors I talked to said that nulliparous women shouldn't use them. But I would encourage people to ask around-- I have a great OB-GYN now who was very supportive of my choice to use Para Guard.

redheaded&crazy

how long are you supposed to spend between insertion and resuming sexual activity?

has anybody noticed any problems surfacing after resuming activity, eg cramps, or anything weird?

realtalk

@redheaded&crazy I had sex two days later. It made my cramps better! Generally speaking, it's made some positions more ouchy, but only at specific times - the two days before and the four days of my period, I don't like really deep-penetrating positions, because of the cervix bumping. (my cervix is a LOT lower during that part of my cycle).

Mingus_Thurber

@redheaded&crazy I was told to wait a day or so until the cramps went away (I have a Mirena).

I don't know if it's related to the IUD or to the concurrent lack of fear of getting pregnant, but I have much stronger orgasms now. That's the only change I noticed, and it happened immediately upon getting the IUD.

parallel-lines

@realtalk Yeah--it should be noted that if you have a lower-than-average cervix you might not want to consider an IUD because sex gets pretty ouchy and unpleasant.

SarahP

@redheaded&crazy Some doctors recommend almost a week if you get the hormonal one, to make sure the hormones have time to take effect. But with the nonhormonal one, you can get going as soon as you feel up to it! (The tenaculum scraped me a little, so my ladyparts were sore--we waited till the next day.)

hellonheels

@redheaded&crazy I was told five days, and waited three. But I was also simultaneously finishing my last pill pack (do NOT recommend - the double hormones made me crazy emotional not just at the time but for a couple of weeks after) so BC efficacy was not an issue - it takes a week to ten days for the hormones to take full effect.

chickaboom

@redheaded&crazy ahh! how do you know if you have a "lower-than-average" cervix?! somehow i think this may be me and i don't even know why. i really want to get an IUD, but now i'm kind of freaked out (never really a good idea for me to read internet commenters' bad experiences on health questions). all of my cavities are small, basically, even though i am an average sized human being, so i'm also afraid i'll be the 30% who have too small of a uterus.

realtalk

@chickaboom during my period I can reach up with two fingers and touch my cervix pretty easily. and that's when really deep-penetration positions are ouchy. your doctor should be able to tell you more!

fondue with cheddar

@realtalk Hm...I can touch my cervix pretty easily too, but my doc said I have a "beautiful cervix"* that is perfect for an IUD. Maybe there's more to it than that? The angle?

*Yes, she actually said that.

realtalk

@jen325 no fair, I want MY doctor to tell me I have a beautiful cervix!! yeah, I don't know, there probably is more to it than a simple length issue? idk. LOLA, HELP!

fondue with cheddar

@realtalk It's definitely the weirdest compliment I've ever received. Anyway, I want to know more about this too!

datalass

@jen325 I'm envious. My eye doctor recently told me that I had "a good looking retina" (no pun intended), and I was thrilled. But that's nothing compared to a "beautiful cervix."

fondue with cheddar

@datalass A Beautiful Cervix, starring Vaginal Mucus and Menstrual Blood. Coming to theaters March 23rd.

255
255

@realtalk Generally I like deep penetrating positions so is this going to be a problem when I get a Paraguard? OR is my love of deep penetration evidence that I probably don't have an ouch low cervix? I'm freaking out reading the comments now as I await my Paraguard appt...

realtalk

@scazza sofija I mean, it might be either, but if it ends up being ouchy, then you find new positions that are also great, yeah? look at it as an opportunity for experimentation?

insouciantlover

I got my Mirena IUD several years ago - March of 2009, to be exact. I love it. I could go on and on about how much I love it. The only thing I'm NOT looking forward to is having normal periods again once I get it removed to try so I can try and spawn.

I mean... not to get too gross here (warning: grossness follows) but I used to find it fairly normal to go through a 12-pack of ultra long overnight pads with wings in the first 1-2 days of my period. Yeah, that meant I'd blaze through a pad every 2 or 3 hours. I dreaded classes that were longer than an hour because I knew I wouldn't make it through them. I mean, I could fill the back of Teen magazine with all my embarrassing period tales from that pre-IUD time in my life.

I love my little magic piece of hormonal plastic.

Bebe

@insouciantlover We are Mirena Insertion Date Twinsies! I was using the Pill for-fucking-ever to regulate my periods (read: skip them altogether as often as possible), and now I....sometimes will get 1 cramp, or a random bloated day and maybe - MAYBE - 1 or 2 days of spotting. But mostly, I get NO period! None! Nothing! I have a pack of pantyliners I bought over a year ago and I've used less than half of them.

Magical Piece of Hormonal Plastic, indeed!

redheaded&crazy

after this past week i'm starting to recall the benefits of being on birth control.

EpWs

@redheaded&crazy Nosy question - has your period deigned to show its face yet?

redheaded&crazy

@The Everpresent Wordsnatcher oh, with a vengeance!

that total jerk.

Jercse

I had my Mirena for a year (post baby) and had it removed a month ago. After a *heavy* and gory three week period I'm still lightly bleeding. Also my husband had some close calls with strings trying to... penetrate. Overall: It wasn't great. It wasn't terrible. But I'm not pregnant, I guess, and that was the point? Either way, I would like my uterus to get itself together and like...um, stop bleeding.

Megasus

OK, so question about Mirena -- since it does have a small amount of hormones, does it still affect sex drive as much as the traditional pill? I decided to go off my traditional BC pills, and have really noticed a difference in my sex drive, so I'm just wondering if Mirena still has that side effect. I don't think I can do Paraguard b/c my period is already pretty hellacious.

insouciantlover

@Megan Patterson@facebook I answered above, but I'll repeat for you. No. I personally didn't even consider the paraguard for the same reasons, and had my doubts about the Mirena due to the way that other hormonal bc had made me feel. My sex drive is just fine, and that's even with my SSRIs constantly beating it into submission.

themmases

@Megan Patterson@facebook No, it's not supposed to. The hormone dose from Mirena is way smaller and it's not really supposed to leave your uterus. Actually when I started having bad cramps with it that were still going on a year after I had it put in, my doctor suggested that the IUD was only helping with some of the cramps because of the very small, local hormone dose. I'm currently trying out adding the pill to the Mirena to check if that helps (so far: kinda).

tortietabbie

I have an IUD and I love it. If it wasn't wedged up in my uts, I would probably want to hug it 24/7.

Though I will say (anecdata, yay) that the first month was HELL. I'd get these sudden, stabbing cramps that took my breath away and made my whole body jerk. I was in grad school at the time and went to the campus clinic to get confirmation that I was, in fact, dying and the nurse on duty (super lady) said what I was feeling was normal and everything looked great up in there and I shouldn't start planning my funeral. I've had it for 3 years now and everything is wonderful.

I definitely second the suggestion of talking to Planned Parenthood. I got mine through a program for "high risk" women (sexually active, no health insurance) who had either recently had a baby or terminated a pregnancy. I paid $0!

blueblazes

@tortietabbie It is a relief to read that someone else had this level of pain for that long. All the ladies in my friend-group have mirena, but none of the others had more than a week of misery. I, on the other hand, had the kind of doubled-over, dizzy, shouldn't be driving or walking or sitting at my desk kind of pain. It was like I was giving birth on and off for two months. BUT, no periods and no babies. And ibuprofen is cheap. The math works for me.

tortietabbie

@blueblazes Yep, exactly!!!

themmases

@tortietabbie Oh god, this is *exactly* what mine were like. I spent all day at work using my institutional journal access to look up what an IUD perforating a uterus looks like on transvaginal ultrasound until they could get me in to experience it for myself. I actually did turn out to have an ovarian cyst but the nurse said it was just as likely that what I felt was my uterus freaking out because it had always been empty before now.

I still get those cramps occasionally (a bit over a year later) but not nearly as severe and I figure my wimpiness just proves that I *need* it to avoid pregnancy/childbirth at all costs. I continue to talk about my lady robot to anyone who will listen.

tortietabbie

@themmases I feel like I need a pin to wear 24/7. "Ask me about my IUD!"

Changeling

@tortietabbie
I went to Planned Parenthood too, with no insurance, and paid $30 total, which I think went to the initial std test. They were quite wonderful.

Megasus

@tortietabbie Gack! Uts!

vivian darkbloom

P.S. I got the Mirena b/c I needed the Progestin since my whack ladyguts won't do their jobs as they should.

laluz

@vivian darkbloom this is interesting because one of the reasons i want to go on paraguard is to see if i can resume getting my period normally without hormones...i went on bc when i was about 20 because i hadn't been getting getting my period for a year - at the time my gyno thought it was maybe because i picked up running? she ran tests and couldn't think of any other reason. anyway, it's regulated my period for the past 6 years but i'm kind of over the hormone thing. but maybe i should stick with the hormones because of this? hm. something to ask my doctor.

vivian darkbloom

@laluz I didn't get a period before my Mirena because I have PCOS. I mean, obviously I've had them BEFORE but they weren't regular and may come about once a year for one day. After Mirena I still didn't get them because it tends to make them stop anyway, but the progestin keeps your lining from building up and getting all pre-cancerousy. But yeah, I'd talk to your doctor about it, and if you don't like what they say check with another.

LydiaBennett

@vivian darkbloom Oh! You answered my question! Ignore it (up-thread)and thanks!

vivian darkbloom

@LydiaBennett You're welcome! It's rather nice to not get a period and also not worry about the precancerous build up. Side note, I'm also on Metformin for my PCOS to help regulate my insulin, lower my testosterone, and hopefully lose a bit of weight. I've not had the bad side effects (i.e. explosive diarrhea) with Metformin that others complain of, but it did seem to obliterate my alcohol tolerance.

LydiaBennett

@vivian darkbloom I tried tried tried with the Met but honestly it made me so sick when I was drinking that I stopped taking it. I couldn't have more than a few drinks without throwing up/ending up really dizzy, and being a 24 year old in a big city, had a hard time with that side effect. I still have a really hard time losing weight, but am managing my insulin with an aggressively balanced diet (ya know, aside from the alcohol that I really should just give up). I have an appointment with my gyn/endocrinologist to discuss Mirena coming up! Excited!

Are They Biting Ducks?

I just want to add in that though I had heavy periods before my IUD insertion, and that they are heavier now, I actually have easier time of the month with it in! It changed my horrid, several-day long, dull cramps into one day of occasional twinging. So, you know, don't be completely put off if you have miserable periods already. :)

noodge

@Are They Biting Ducks? same with me - i used to get horrible total-abdominal cramps for days, now it's just a day or two of more pin-pointed discomfort in my cervical area. waaaaay better.

SarahP

@Are They Biting Ducks? ME TOO. Pre-IUD, I had cramps so bad they would make me fall down (ie, my knees buckled). My Paragard made me have longer cramps (2 days), but like 1/4 (or less) of the pain. Thanks, little copper buddy!

Changeling

@Are They Biting Ducks?
Before the paragard, my period used to sneak up on me, but now I get little warning twinges two days beforehand. It's useful!

TARDIStime

@Are They Biting Ducks?
Copper or Mirena?

Craving Brownies

So glad I decided to read the hairpin in the parking lot instead of running straight to my cube! I have had a Minera for 3 years and LOVE it. I have never been pregnant and had a rough insertion. The NP had to use little rods of increasing diameter up for enough room for the insertion tool, but the 10 minutes of serious discomfort was well worth it. Then I went home and laid in bed for 2h before going about my day. Around my period I had cramping for the first couple of months, but they were individual moments of pain, not hours of agony (although at times it was like a sharp kick to the uterus). 3 years later, I have no cramps, a super light period, and no babies. It's fantastic for me since I travel to Asia for work and I don't have to worry about the time change and keeping my pill routine.

insouciantlover

@Craving Brownies Oh, you bring up an excellent point. Since my uterus is an asshole it would kick into gear any time I did any traveling. Vacation to Mexico? PERIOD! Going to Burning Man for a week? PERIOD! It's so nice to not have my period hold me hostage anymore.

redheaded&crazy

@insouciantlover ugh tell me about it. both times i went on vacation this year, i got my period one day before travelling. travelling on your heavy day is no fun at all. no fun at all.

although it's definitely better with the diva cup (not trying to be an obnoxious diva cup plugger here, just sayin)

Ophelia

@insouciantlover I have a theory that my uterus responds to the pressure changes of flying. 30,000 feet? Wheeee! Period!

realtalk

@redheaded&crazy Iiiiiiii had sex three days later (as soon as the cramps subsided) and it was fine! Really deep-penetration positions are not funtimes in my pms/period week, but that is only 7 days per month max, and I think it's because my cervix is lower then. Definitely work-aroundable.

themmases

Oh my god yesssss I love talking about my IUD! OK, scrolling back up to read now...

noodge

i called my local family planning office at my local ivy league medical school hospital about my concerns about paying for my iud (Mr. Teenie was out of a job at the time, and I'd just had my fourth m/c in 1 year, after stopping birth control pills that I could barely afford but made me truly insane) and they said "oh hey! come on down, we'll cover it all!" and they did! there was a fund set up there by some rich woman (who clearly is one of the most kick-ass women ever) to cover birth control costs for women who couldn't afford it.

So, I guess, call your local hospital (especially teaching hospitals?) and see if something like that exists there if you're in a hard spot and need good birth control. Especially in states (like Pennsylvania) where insurances haven't been required to cover birth control.

tortietabbie

@teenie If I ever become wealthy, that's exactly the kind of thing I want to do.

Lola P.

@teenie you rule teenie! you reminded me--here's a list of states in which birth control must be covered by insurance

SarahDances

Wait, hormonal birth control when you have CIN is a 2, but copper IUDs or progestin-only pills are a 1? Why is this? How are hormonal birth control and CIN related?

Mingus_Thurber

@SarahDances If I recall right, which may not be right at all, estrogen can make the immune response in your cervix go wonky. How, exactly, I don't remember.

hellonheels

@SarahDances This is weird to me too. I was diagnosed with HSIL which turned out to be CIN a couple of weeks before my Mirena insertion appointment, and when I asked my doc if maybe we should just deal with the colposcopy, etc. first she was like, "Absolutely not! Let's get this IUD in first!" So, I don't know.

Relatedly, my doctor is awesome.

hallelujah

This is great! Ask a Nurse, you are a revelation! Also pregnancy = baby infection made me laughhhhh.

Follow up: how long must you wait after you have a child to get one of these miracle devices?

realtalk

@hallelujah they can do it immediately (as in, right after you deliver the placenta) but some doctors prefer to do it after your uterus has mostly returned to its normal size!

Jercse

@realtalk I was told there was a higher risk of the IUD coming out on it's own if done too soon? Something about the cervix not closing enough until about 6 weeks postpartum?

miwome

KOALA!!!

EpWs

@miwome If all gynecologists' offices kept koalas on staff we'd all be a lot more enthusiastic about going.

miwome

@The Everpresent Wordsnatcher Also, candy. Not lollipops, though. Something less suggestive, like maybe Skittles.

Mingus_Thurber

@The Everpresent Wordsnatcher At Ye Olde Planned Parenthood where I worked, we had a couple of clients who used to bring in their bottle-fed baby goats (BABY GOATS OMG SQUEE) when they came for exams in the spring. Apparently you can't leave rejected BABY GOATS alone for very long, so we'd snuggle them behind the counter. Another client had a hearing-ear monkey, a capuchin, who would ride around on my shoulder or, more often, atop my head while the client was getting her exam.

Reading back over that makes me more convinced than ever that I actually live in a children's book.

miwome

@Mingus_Thurber The only thing that could improve this scenario is baby sloths. PS I would like to live in said children's book, where do I apply.

EpWs

@Mingus_Thurber MONKEY ON YOUR HEAD. You live in a magical land.
@miwome Really good chocolate. Those little Dove squares would be lovely.

Mingus_Thurber

@The Everpresent Wordsnatcher MONKEY ON MY HEAD who tried to play with my freckles!

A guy walked in one day to pick up his girlfriend's pills, and the monkey was visiting my head. As I sold him the package of pills, he said, "Uh. . .you do know you have a monkey on your head, right?" I replied brightly, "It's Anything-Can-Happen Day at Planned Parenthood!"

EpWs

@Mingus_Thurber AMAZING. I want to go to thereeeeee.

Ophelia

@Mingus_Thurber If that PP is anywhere near the NYC area, I want to switch all of my care over to it.

LeafySeaDragon

@Mingus_Thurber I WANT A BABY GOAT!!!

EpWs

@Ophelia If it's anywhere in the Ohio Valley area, I'm switching all MY care over to it. This is a brilliant marketing plan for PP. "Come to Planned Parenthood, we have baby goats!"

Ophelia

@The Everpresent Wordsnatcher "If you don't want a baby, come borrow one of ours! They're not the same species, but that's OK."

EpWs

@Ophelia "If you don't want a kid," you mean. :P

miwome

@Ophelia I was gonna be all, "OR IF IN THE BOSTON AREA" but then I remembered I moved. So instead I will just tell y'all that apparently here in Cairo you can get birth control OTC. Let me repeat that. You can get birth control OTC in CAIRO BUT NOT IN THE US. So, yeah, those Mooslims are sooooo terrible re: ladies, amirite?

PS I like to think PP is in the business of Anything-Can-Happen-Day everywhere they're active, all the time!

She Saved The World, Alot

YES! I just got off the pill and I am slowly considering getting an hormone-free IUD! And this is PERFECT!

(Also, guys, I had my first hormone-free period since I was 18! And it wasn't the nightmare I had been expecting! And I *think* I've also been nom-nom-nomming a LITTLE less since stopping the pill a month ago! And I'M GETTING IN TOUCH WITH MY REAL HORMONES!)

Now back up to read the aritcle weeeeeeeeeee

miwome

@She Saved The World, Alot Getting in touch with the hormones is weird, yo. I started the pill when I was like 13 and had my first non-pill period since age then at maybe nineteen or twenty. I was like, "WHAT is this CRAVING for CHOCOLA--ohhhhhhhhhhh."

She Saved The World, Alot

@She Saved The World, Alot It is SO FUNNY that you mention this, because last night at 9pm I ran out of my apartment in a tizzy to search of chocolate non-pareils and those little lemon gummies in the shape of lemons. I tried to resist for about an hour but my hormones were like NOPE! YOU NEED CANDY.

Unfortunately, the non-pareils were TEN BUCKS (what the fucking fuck!?) so I got chocolate covered pretzels with sprinkles BUT IT JUST WASN'T THE SAAAME.

Ophelia

@She Saved The World, Alot I don't even LIKE chocolate, but for period-time, only the darkest, bitterest stuff will do.

alebee

@She Saved The World, Alot Unrelated but OMG WE HAD A FRAMED PICTURE OF THIS ALOT IN MY OLD APARTMENT. I love you. Can we be friends, please?

She Saved The World, Alot

@Ophelia I always follow up dark chocolate with orange juice. ALWAYS. If there is no orange juice in the vicinity, I either have to run out and buy some, or post-pone chocolate eating.

@alebee Yes, friends!

WastedPaper

I was an IUD baby! So I'm assuming it may have been improperly inserted? And also I think it's still swimming around inside my mother somewhere? Argh - I forget the details! (note to self: must. call. mom.)

realtalk

@WastedPaper an IUD and a baby can't occupy the uterus simultaneously (I THINK???), they probably pulled it when she found out she was pregnant and decided to keep you! she may have gotten another one after you were born, though.

CWmom

Actually, I have a son who will be 2 next week who was conceived with my Paraguard in. He is my third child, and I felt pregnant, and peed on the stick, and miracle of scary miracles, it turned blue! or pink! or whatever. Ultrasound showed little baby curled up on top of the IUD like it was a cozy hammock. The IUD was perfectly placed. I was pretty stressed out, had to have intrauterine surgery, was given terrible odds about a successful pregnancy, and was dealing with conflicting emotions about the baby (I mean, I had that Paraguard in for 2 years! I was not planning on more children at all). It all worked out for us in the end, but the realities of getting pregnant with an IUD in are more dangerous than getting pregnant while on the pill. If I had to, I'd probably still get the IUD, but would like to have been more informed about the "what ifs" of conceiving with it in!

insouciantlover

@CWmom lulz cozy baby hammock

saul "the bear" berenson

@CWmom Truly no offense intended here, but can I put in a request for Lola to verify the possibility of this? Since it's CWmom's only comment on the site and this idea of the "little baby curled up on top of the IUD" is a little outrageous-sounding to me... I would appreciate some other insight? Congrats on your bundle of joy and all that, of course, I just feel weird reading this.

CWmom

@WastedPaper I have a ultrasound image and an actual color photo of the fetus that the doctor took while removing the IUD. You can't tell what it really is though. My high-risk doctor told me that the reason my IUD failed was because of my husband's super strong sperm. The IUD creates a terribly hostile environment full of mucus and high-ph. But hubby's sperm withstood. I am an anomaly. It's very rare. And I did see like 5 different doctors. When we saw the placement of my son ON TOP of the IUD the image was just a little joke. We thought because of the baby's little spot, it would be impossible for the IUD to be removed without terminating the pregnancy. But it all worked out.

CWmom

@Moxie We also joked about naming him "Mr. T" or "Iudina". But really, it's true.

WastedPaper

@realtalk I called my mom! She said that the doctor examined her after I was born and he couldn't find it. So it might have fallen out and she didn't notice?

realtalk

@WastedPaper hahaha, what. it probably apparated away???

SarahP

@WastedPaper MAYBE IT IS IN YOUR BRAIN eeeeeek

WastedPaper

@realtalk ahhhh! now I want to call her back - she loves harry potter! But yeah - who knows?

WastedPaper

@SarahP NOOOOOOOOOOOOOOOO

Lola P.

@WastedPaper YES! this is often how people get pregnant "on the IUD:" there's been an expulsion, the person doesn't notice because expulsion can often be "silent," and there you go. hence the string checks.

realtalk

@Lola McClure WHAT HOW DO YOU NOT NOTICE IT FALLING OUT?? i'm so confused

TheCheesemanCometh

@CWmom My high school best friend's older sister was born with their mom's IUD in her scalp. It's totally possible (although given her age this would have been in the late 60s, I think, so different technology.) That story freaked me out, so I never considered one. She also had several miscarriges between the two successful pregnancies, but I don't know if tehy were IUD related.

Lola P.

@CWmom whoa, you are a super rarity! thank you for sharing your experience and i'm super impressed by your humor with it all. somewhere else someone suggested "penny" for a paragard kid--if i ever have reproductive sex again i'm keeping that on the shortlist.

Miss Violet

@TheCheesemanCometh My second sister was an IUD baby, born in 1980. My parents were so scared that she would be born with the IUD in her somewhere - but miraculously there was no sign of it. But there was also no sign of the IUD in my mom - and she got pregnant again two years later with my third (and final) sister. Then, 25 years later, my mom was having a large fibroid removed - while in surgery the doctor also discovered old IUD, lodged in her uterine wall. (It was unrelated to the fibroid, but he went ahead and removed the IUD too, at long last.) I'm sure the new devices are more advanced than what my mom had, but I confess that I'm just too scared something like that will happen to me. PIlls, please.

heyladies

This is some serious advocacy journalism right here. Info I very much needed as I was pretty sure I wanted to get on board the IUD train post-second baby (coming very, very soon) but needed that extra convincing. THANK YOU.

cmcm

I think I will have to put myself in the "nope" box for no other reason than the fact that reading this made my uterus hurt and made me feel a bit queasy.

I am a wimp. But on the plus side, I never forget to take my pill so I might as well stick with that.

EpWs

@cmcm Ditto. After my LEEP a couple years back I want nothing sharp up in my uterus pretty much ever again.

ylime

Thank you for posting those links to NeedyMeds, I think I qualify! What up, poverty!

miwome

@ylime WHAT UPPPP

brista128

Baby infection lollollollol

combledore

I've had an IUD since July, and I absolutely love it. My OB/GYN refused to even consider insertion, since I've never been pregnant, but Planned Parenthood did it no questions (well, besides the actual medically necessary ones). I had been on the ring, but wanted to get off because I didn't think it was helping my anxiety disorder. I love my Paragard. Periods are heavier but nothing that three Advil won't take care of, in my case. And all for $40. Thank god for my health insurance.

saul "the bear" berenson

This is beautiful and fabulous and hilarious and wonderful! I am getting a Paraguard in a couple weeks and have been trying not to freak out. This helps so, so much. Thank you.

LRMG

@Moxie It is a super YMMV situation with the pain/insertion but mine was not so bad? I recommend taking a few Advil or Aleve before going in, I think it helped, especially because I had some cramping afterwards.

beeline96

@LRMG I second the meds (I took ibuprofen) and also recommend positive thinking! It's like donating blood - it can be painful, but if you close your eyes and think about something else, it's over soon enough, and something good comes out of it! (No baby infections.) Juice and cookies are also called for.

themmases

@Moxie Ooooh, good luck! For most people it really does turn out to be worth it. My doctor told me to start taking Advil that morning or the day before, and to take extra before I came in. I have no idea if that helped or not, but unless you have a health reason not to take it it can't hurt.

Mine was definitely uncomfortable, but it is quick (I was even smaller than the doctor expected, and it was still quick). After she took one look at my face-- I'm pretty sure I looked a little green-- and asked if I wanted to keep lying down for 10 minutes. I did that, took some deep breaths, and was fine to walk back to the bus after that.

Changeling

@Moxie
Oooh good luck! I had a great paragard insertion, just a few seconds where I said "owie owie" out loud (I brought play dough to squeeze in my hands to take my mind off of it) and cramps for the next couple days. One of the best decisions I've ever made.

CaddyFdot

@Moxie Do not freak out! I got one in September of last year (October?) and the insertion was NOT as bad as I expected. The cramps during my first two IUD periods were pretty bad, but like someone upthread said, a few Advil mostly took care of them, and also the sticky, one-use heating pads you can buy at the drugstore were AWESOME. I used the ones for the back of your neck/shoulders which turned out to be the right size/shape for my lower belly. The periods since then have had much less cramping, though still more than the minimal I used to have, but they aren't too bad. It's heavier for a few days, which I don't mind, but I do mind that the end sort of trails on for days with an almost-nothing-but-not-actually-nothing flow (I keep Always in business with my ultrathin pantyliner purchases). I'd take another heavy day or two in exchange for the four additional annoying light days.

saul "the bear" berenson

@Moxie Just wanted to revisit this old thread to report that my Paraguard was inserted on April 2nd, a week and a half ago, and it was really quite easy and awesome!

I was nervous, but decided to operate in the mindset that it was Not a Big Deal, which worked really well and kept me from totally freaking out. My doctor remarked on how relaxed I was, and how that can help make things go smoothly. Reading here about how pain has to do with expectations of pain convinced me to just say to myself "This is totally cool and a normal thing that will be pretty easy, and you are a strong woman who can do this, no sweat!" So it was cool that that actually worked.

The insertion took maybe 3x the length of time of a normal pap, and was not painful, just weird feeling and kind of achey. There was a "someone is doing things to my insides and this is quite weird" feeling, but it was not painful - and I definitely didn't have any sharp pain, which is what I had been so afraid of. Just achey, like cramps.

Afterwards I stayed in the doc's office for maybe 15 minutes, and then cabbed it home and hung out in bed for the rest of the day. I felt like I had bad menstrual cramps, but once again, I had been afraid of feeling sharp pain, and there was none of that. After that day, I had on-and-off cramps for a couple days, but they were barely even noticeable.

Overall the whole thing was a total breeze compared to my worst-case scenario fears, and I was really grateful to the Hairpin, this article, and all the comments for making me way more relaxed and educated about the whole thing. Thank you!!!

LRMG

Also when I went to get an abortion (thanks other failing forms of bc) they told me that I could get the abortion and IUD done all at the same time. A lady who I was waiting in the pre-abortion room with was getting that done, and no I didn't ask her, she told me via her loud cell phone call. I didn't do it because of the upfront money, the abortion was already taxing my wallet. I got it later through a pharmacy copay situation.

mlle.gateau

I LOVE MY PARAGUARD. I will say that the first few months were rough, but I've only had one really terrible period, and since then things have really normalized. I think a lot of ladies have trouble with their periods afterward if they switch from the pill to the IUD- it's not the IUD, but the non-pill periods that are A Thing. I've had mine in for about six months (I should really buy my copper warrior some flowers and chocolates), and I don't even think about it anymore. It's just there, defending my uterus against wayward sperm.

Insertion was a bit of a bitch, but then I have gyno-anxiety and xanax up for annual exams, but I had it in on a Monday and was back at work the next day and exercising normally by the end of the week. I think most of the downtime was related to the fact that I had to take slightly more xanax than usual because the insertion takes longer than a pap smear. Anyway. I also strongly recommend getting more exercise than usual if you're stopping the pill and switching to either IUD, because the exercise can help regulate your hormones and mitigate swings and severe cramp.

IUDs FOR EVERYONE! (Who wants them, please use the contraception of your choice).

agba

Hey Lola (or anybody), can you please explain "distorted uterine cavity" (on the lovely construction paper graphic)? I've been told I have a "tipped uterus" but don't know what that means or if that qualifies as a distortion.

LeafySeaDragon

@agba me too! it's also been described as backwards.

combledore

@agba I've been told I have a tipped/tilted/whatever uterus, and insertion wasn't a problem. I mean, it wasn't fun, but no problems.

agba

@LeafySeaDragon Hahaha yours is even better! Like it's too old-fashioned or something, while mine is just drunk and falling over. (It probably is.)

SuperGogo

@combledore Good to know! I just freaked out about this downthread. Tilted ladies unite!

Maven

I logged in solely to give this article, and the style in which it is written, a million thumbs up.

a small sea

I've been on oral daily BC for the past 5 or 6 years and I'm weirdly convinced that if I ever go off it, my skin will break out like crazy. I never had terrible skin but starting BC (at age 17) made it nearly perfect and it's been pretty great since then. I assume the hormones of a 23 year old are different from a 17 year old and I know its just vanity but... would switching off daily BC to an IUD (with or without hormones) take me back to high school teenager zits?

Ophelia

@a small sea Not sure, but I stopped taking hormonal BC at age 30, and while I do notice a few zits around the time I get my period, I definitely did not revert back to teenager skin (although I also didn't have particularly zitty skin in high school anyway).

Norrey

Great article! I have a irrational fear of them, that I am trying to get over. My sister got pregnant on an IUD. She terminated it (cause, you know, she had an IUD because she was so not wanting/ready for a baby). I know is happens, and it's super effective, but you know how one scary story tricks your mind into being stupid sometimes? Anyway, I'm gonna try and figure that out, because my partner and I have been using condoms for three years and it's getting annoying.

tortietabbie

@Norrey That's my biggest fear. I mean, getting pregnant at any time is my biggest fear, but with the IUD even more so. Because you'd have to get it taken out, terminate and get it put back in and I imagine the whole process is hellish. But...so far so good.

Norrey

@Norrey Yeah, but the take home I guess is that it's really uncommon. My sister was getting a bunch of "OMG, I'm so sorry, that really sucks" from nurses and doctors though the whole process.

Possibilitrees

@Norrey My mother actually had a Paragard when she got pregnant with me, so I've always avoided them myself. Your fear doesn't sound at all irrational to me!

Sea Ermine

@Norrey From what I've heard removal is pretty painless (although I don't know if removal while pregnant is the same thing) if that helps to hear. Plus your chances of getting pregnant with and IUD are lower than your chances of getting pregnant while using condoms of birth control pills so while obviously if you were to get pregnant with an IUD it would really really suck (understatement) you overall chances of having that happen are pretty low.

noReally

Not jacking the thread, but reading about heavy periods and how people hate them, must shout out for the uterine ablation procedure. I used to bleed like a horror movie. Got ablation, where they basically cook the inside of your uterus, so lining doesn't grow like it used to, and now I have almost no period. Wheee. Not for people who still have childbearing on the schedule (though it doesn't count as sterilization, so the line is basically, you probably can't get pg if you want to, but you might get pg if you don't want to), and an actual full-blown anesthetized outpatient surgery. But oh boy am I a happier girl.

TARDIStime

@noReally
I had never heard of this.
*Googling ensues*

Leanne

I got my ParaGard 2 months ago, I'm very pleased. I didn't realize what the pill was doing to my sex drive until I wasn't taking it anymore.
-Insertion was very painful for me, and I am not a pansy. However it was only about three seconds of blinding pain, followed by a day or two of dull cramping. Nothing I wouldn't do again.
-So far my period has been longer, but not significantly heavier.
-The cramps have been pretty bad. Everything I've read though says that they subside after 3 months, so I'm hanging in there.
-Boyfriend claims he can feel the strings occasionally, but I suspect he's imagining things. I shouldn't have mentioned them. *shakes fist*
-My crummy insurance covered the insertion but not the actual IUD. I'm paying in monthly installments of $65 for 12 months.
-My gyn was very happy to discuss it with me and was non-judgey. I have never been pregnant or had kids and this was not an issue. Everyone in NYC go to Cityscape! They are the best!

Overall, I give my ParaGard two fallopian tubes up.

LeafySeaDragon

@Leanne guys can feel them, my guy could at least. we didn't have sex in a lot of position because they poked. it's a wire that pokes them in the head of the penis... i can't imagine that is pleasant.

SarahP

@Leanne For the first 4-5 months I had my Paragard, my husband could feel the strings on day 18 of my cycle. (I chart my cycle, sorry if that sounds really OCD), not any other day. After 4-5 months, he wasn't able to feel them at all. (They soften over time, but also they just went to their forever-home behind my cervix.)

Leanne

@SarahP thanks! I chart, too - I'm going to take note of when he comments on it.
@leafyseadragon good to know. I have to see my dr for a follow up appt in a month, so I'll have her cut them a little shorter.

tortietabbie

@Leanne They will definitely soften up and disappear over time. I asked my dr to cut them, too, but she advised just giving them time. My partner feels them occasionally in certain positions (I've had my IUD for 3 years) but it's more of a "neat! I felt a thing!" response than an "ouch! my dick!"

realtalk

@LeafySeaDragon they only poke if they're cut too short. mine coil around my cervix so the ends are like, not pointing toward the exit at all.

beeline96

@SarahP BAHAHA forever home.

SarahP

@beeline96 I have been reading SPCA listings lately.

singstrix

WAIL, I desperately want[ed] [[want]] to get a Mirena, and my GP (a CFNP) was TOTALLY on my side. So I went merrily (?) of to get my trans-vag ultrasound, only to find out that I had a fibroid, which, originally scary but ultimately OK. BUT THEN my health insurance actually specifically does not cover "birth control devices", because ???

SarahP

@singstrix Mine covered the procedure but not the device, which was frustrating. (Well, I had to pay it out of my deductible. So I guess if I'd met my deductible they'd've covered it.)

DrFeelGood

@singstrix Try Planned Parenthood, you pay on a sliding scale based on income. That's how I got mine for ~$100 bucks instead of around a grand.

singstrix

@DrFeelGood Thank you; that is a really great idea, and one I wouldn't have come up with on my own. I was just in the brain-trench of 'go to GP, have GP do whatever, blah blah insurance.'
Also, as a tangent to what @SarahP said, I could stand to find out if my FSA would cover the IUD itself?

theharpoon

CYBORG MANIFESTO FTW

SarahP

@theharpoon Within a couple months of getting my copper IUD, I also got a titanium dental implant. My then-boyfriend, now-husband was playing a lot of Bionic Commando at the time, but he still didn't think it as funny as I did that I started referring to myself as his Bionic Girlfriendo.

QtheQuidnunc

If anyone ever decided to make a Lifetime Movie about me the title should be, "From My Cold Dead Uterus: A Woman and Her IUD. A Love Story"

I've had my Mirena for over a year now and it's great. My reasoning was complicated but man, I'm so glad my mother recommended it. The cramps were awful initially but my periods now are pretty much non-existent. My "heavy" days now are like my light days pre-IUD. I haven't touched my motrin in months. The only side effect I've noticed is that sometimes I get cramps when I'm hungry, which is kinda helpful since I sometimes forget to eat.

I "paid" for mine through a Medicaid program in Michigan that covered family planning services for poor people (http://www.michigan.gov/mdch/0,1607,7-132-2943_4853_51959---,00.html) I know other states had similar programs as it was a federally funded program. I'm not sure if it's still active. But the IUD and all my lady business related needs were completely free.

Stowaway

I didn't have the experience of my doctor advising against me getting one, but she didn't suggest it, either. Like, I said, "Hi, I am going on a two-year trip around the world; what should I do for birth control?" And she said, "We could double up your prescription on your current BC pills." And I said, "I was more thinking something hands-off like an IUD?" And then she was all, "Oh yes, I think that would be great" even though I have never had a baby and have a tiny little cervix. I am scared about the insertion and may call a friend to hold my hand and put me in a taxi afterward.

QtheQuidnunc

@Stowaway Seriously, take some Motrin about 20 minutes before you go in. It makes all the difference in the world. Everyone's tolerance for drugs is different but I did 600mg.

nonvolleyball

@Stowaway I've had one inserted twice (the removal was done while I was under anesthesia so I can't report on that, long story), & it was pretty "unpleasant" both times (to use the medical community's favorite euphemism for pain). but the immediate aftermath wasn't any worse than bad cramps. take a hearty dose of ibuprofen beforehand, keep up with the painkillers afterward, & have heating pad ready.

& don't do what I did after the first insertion, which was watch Eraserhead while my sister-in-law was about to go into labor with to her first (unexpectedly conceived) child at any minute. don't watch Eraserhead if you're having any thoughts at all about child-having, actually.

SarahP

@QtheQuidnunc I did the same thing, which I think helped with the cramping (because I didn't have much cramping at all after insertion). My husband drove me because he was really nervous for me (I was nervous too, because I didn't know what to expect, and held his hand so tightly it was red for a while afterwards), but I would have been able to take the bus. (In fact, I had my insertion at 8:30am, and went straight to a full day of work afterwards.) Just try not to be nervous!

Stowaway

@QtheQuidnunc Thanks! I will take all the drugs allowed, for sure.

Stowaway

@nonvolleyball Definitely no Eraserhead! My recovery period will be spent watching period dramas, where no one even talks about childbirth and they probably all actually believe in the stork method of delivery.

Roxanne Rholes

@Stowaway I had pretty much the worst insertion experience of all time (like, extremely scary physical reactions to it) and let me tell you: in the incredibly unlikely case that things go poorly, you want to be as prepared as possible! Definitely bring a friend or your man or someone. Don't even go if you're going to be alone! Don't! Don't plan on public transportation. Take two days off (or do it on a Friday.) And! Get thee to the drug store and get the disposable hot packs that are supposed to go on your lower back and stick 'em to your lower belly. Works wonders and is definitely worth the few dollars they cost. And, when it goes well, which it probably will, you can chuckle about how now you get a free day off from work.

Also..."period" dramas. Har har!

beeline96

@Stowaway Did everyone skip the part where you're GOING ON A TWO YEAR TOUR OF THE WORLD??? Congratulations! That's so awesome!! I'm jealous. Have a great time - you're going to do crazier things (I think?) than get an IUD inserted. Hopefully less invasive, but, you know.

Stowaway

@Roxanne Rholes Haha I didn't even do that on purpose. I am just so IN TUNE with my moon cycle that it wrote itself.

Also, thanks for the tips! I need to get these heating pads, stat.

Stowaway

@beeline96 Thanks! I am super excited to finally take a trip I've been planning for, oh, eight years.

I can only hope that some of the crazy things I do will necessitate having a birth control plan.

Passion Fruit

@Stowaway GOOD FOR YOU! So jelly and so proud (in an internet stranger way).

Stowaway

@Passion Fruit That is the best way?

Baby amounts of self-promotion, in case you want to follow along, my Hairpin profile has the website for my blog. I will endeavor to fulfill all your armchair traveling needs.

alex hart

I love my ParaGard so much. Insertion is no biggie as long as you can go straight home afterwards and lie down and drink, like, two medium-sized glasses of wine.

One really cool thing about ParaGard is that, from what I understand, it basically turns your body into a sperm death trap. How neat!

Here's Planned Parenthood's page on IUDs: http://www.plannedparenthood.org/health-topics/birth-control/iud-4245.htm

Palmetto

This sounds really cool. My question is if an IUD like Mirena helps with IBS symptoms? That's why I take the pill, but I'm really intrigued by the IUD now.

gobblegirl

@Palmetto I did NOT know that the Pill helped IBS! That is super fascinating.

annev6

This might be TMI, but my doc told me I could not have an IUD because my body had started to kind of "reject" the NuvaRing after being on it for years and years (lots of spotting, some discomfort). I was disappointed because the IUD sounds so much easier than the pill! Is my dr just being paranoid, you think? Or do some people's ladybits just start throwing tantrums after awhile and must be left alone??

SarahP

@annev6 I'm calling shenanigans on your doctor, if that advice is only based on the fact that the NuvaRing was not for you. The NuvaRing doesn't go in your uterus, so how your vagina behaved with a NuvaRing does not reflect how your uterus will behave with an IUD. I would talk to a different doctor about your options.

realtalk

@annev6 maybe your doctor was talking about the hormones??? definitely get a second opinion! and if it's hormone-related, talk to your doctor about paragard!?

annev6

@SarahP That's a good point. I really like my doctor, but she may have been playing it safe since we could never really figure out why all of a sudden I soured on the NuvaRing. And man, do I HATE the pill. HATE HATE. HATE.

DrFeelGood

@annev6 Honestly, I would talk to someone at Planned Parenthood, or a GYN who does many (20 - 50+) insertions a month. My regular doctor who does my gyn exams was clueless and told me really REALLY bad shit that was not true at all and very confusing to me. PP were the ones who cleared up EVERYTHING for me.

realtalk

@DrFeelGood oh man, this this this. A NP at a women's clinic did mine, and she was super helpful with all of my questions. Also, she puts in like 5 a day, so she was in and out of there so fast! like, speculum insertion, uterine sounding, insertion, speculum removal within 5 minutes TOPS.

Lola P.

@SarahP agreed. MAD shenanigans. get a second opinion!

RocketSurgeon

Gotta throw in my experience story, too:
I'm 32, no kids and with a long-term live-in boyfriend. I got a Mirena about a month ago, and I'm a big fan so far. It was covered by my insurance, but with a $120 copay for the insertion, etc. The insertion was uncomfortable but overall fine, though the doc did give me epinephrine to constrict my blood vessels and reduce bleeding. I underestimated how jacked up and speedy I would feel, but it wore off in 5-10min. The insertion was done only a couple days before my cycle was due to start. I had two days of mild cramping, and intermittent mild spotting after my cycle for a week or so.

I'd been on the pill for over a decade, and it's been nice to feel the effects of birth control slowly leave my system (no weight loss reward so far, though). My mood has been more even recently, and sex is even better now. And Mr. Boyfriend says he can't feel the strings, either.

As of now, I really recommend it as an option for people in a situation similar to mine who are comfortable with the risks.

SarahP

While we're sharing IUD love, I want to chime in! I've had my Paragard for a year and a half, and it is the best! I got it when I was 24, never having been pregant. I was not on my period during insertion, but due in 2 days. (I guess that's when your pain threshold is lowest? Oops.) My insertion was a breeze--there was a really painful period of 10-15 seconds when I was sounded and then it was inserted... but then it was done! I had mild cramps that day and the next, but did a full day of work both days. My periods have increased in length by 1 day (it used to be 3-4, now it's 4-5), and I now get ovulation cramps, but other than that my quality of life has not been affected. (Except, as I mentioned in a comment above, I used to get CRAMPSFROMHELL before my Paragard, but the Paragard made them easier. Also sex is more convenient. So I guess my quality of life was affected, for the better.)

Ruby

Paragard IUD is the best thing that every happened to me. IUDs FOR EVERYONE!!!!! It's too bad that they have such a stigma in the U.S. It's the most popular form of BC worldwide. (Especially in Latin America and Asia, I think?) I got mine in Korea.

Lola P.

@Ruby korea has the highest IUD usage rate of any country: 49%!

Ruby

@Lola McClure Oh interesting! Thanks Lola! I got the "Copper T", so I guess it's not technically Paragard, but pretty much the same thing? The doctor in Korea said it would last for 5 years, but doctors here all say 10. I wonder why the difference? Different research in Korea? I've been curious about it, but not too worried...just planning to keep it for 10.

Unaccompanied Lady

I'm on my third Mirena. No periods and never a thought ever about birth control is worth the couple hours of not that bad cramps and what felt like an aggressive pap smear having it taken out and put back in.

That vasovagal is totally a thing -- I passed out once in the Dr's office but the next time I just laid around reading People for 30 mins and was fine. <3 u, mirena.

QtheQuidnunc

@Unaccompanied Lady OMG yes the vasovagal is a thing. It's worse when you have no idea what it is and wth is going on.

C_Webb

@Unaccompanied Lady I get them all the goddamn time -- I've even had seizures from extreme episodes. Only "medical procedures" for which I didn't have them? Childbirth. Twice. I was more afraid of passing out during the epidural than I was of pain. I didn't freak when my Paraguard was put in, but I'm due for another one this spring and I'm feeling pretty Dready Dreaderson about it.

Mingus_Thurber

@Unaccompanied Lady How'd the removal/reinsertion feel? I'm getting mine removed/reinstalled in three weeks, and I'm curious. The first time was very, very weird, as in slightly painful, but more crampy and strange, and I could feel the Mirena unfolding in my uterus, oh hai what's up internal organs?

Unaccompanied Lady

@Mingus_Thurber Sure it feels weird, but no big. Having it put back in is more painful. Do deep yoga breathing. Tensing makes it worse.

undercoverhippie

Throwing my story into the ring, too. It seems like stuff is all over the board. I got the Paragard three months after having my daughter. (Can we please discuss how shitty the post-baby contraception options are if you're breastfeeding? They suck.) Accourding to the data and flow charts above, I was an ideal candidate. My midwife was like "let's do this thing!" and I was all "Yes! No more babies for 10 years!" It did...not go as planned. Insertion hurt as bad as my unmedicated labor, I had cramps, and then by body decided to be among the exceptional few which expells the dang thing 2 weeks later. (I am not the only expeller I've met. 2% seems too low?!)
But... this article is so upbeat that I am almost tempted to try again?!

katerrific

@undercoverhippie I expelled also. Twice. But I've never had a baby and so I guess there is a higher risk in that instance. I had to go back on the pill after the second expulsion, but my doc said if I eventually do have a baby and then want to try the IUD again, my uterus might be more like "meh, whatever." Despite the painful insertions and my bad result, I would still jump at the chance to try it again.

SuperGogo

If your uterus is tipped and pelvic exams are already hellacious because reaching the cervix takes some finnagling and you've never had a baby, an IUD insertion is probably DEATH ON A STICK (literally), right?? A friend wants to know.

Ruby

@SuperGogo, I have a tipped uterus too and have never had a baby! Insertion was a breeze-I mean yeah there was pain, but it went by so fast that it doesn't even matter. As others have said, you just take ibuprofen beforehand.

SuperGogo

@Ruby Thanks! Another "tipped" lady commented upthread that her insertion wasn't any worse because of it. Yay, good news of a Monday morning! Can you really want anything more??

lalaura

I, too, <3 my Mirena! Yeah, the insertion was uncomfortable, but no more than a bad period. I had some spotting for the first few months. But for four years, it's been effortless birth control and no periods. Who could ask for anything more?

A note about PIV sex: For the first month or two, my partner would occasionally feel a little poking from the hanging strings. But they softened up after that, and no partner of mine has noticed the IUD at all for the past four years.

MissNelson

A quick comments-searching didn't pull up anything about hair loss... has anyone else heard horror stories about hair loss after Mirena insertion? That and the hormones are the sole reasons I'd rather go ParaGard. I don't want to have bald patches, no matter how not-pregnant I'll be.

Lola P.

holy shit, the hairpin HATES! the way the managing contraception links are formatted. here's the text i was trying to link:

"There are clinicians who have inserted Mirena IUDs extensively who have never had a patient who lost hair using this method. So your problem is not a common one...In the 2005 Physicians Desk Reference the adverse effects of Mirena include hair loss in less than 3% of women. Hair loss was an adverse effect of Norplant implants, another very low-dose levonorgestrel contraceptive. Hair loss may also occur in women on combined oral contraceptive pills. In sum, hair loss may occur in users of most hormonal contraceptives."

so, the connection does exist, and is very small. my part is to give you the numbers and explain them in context; here, it looks like mirena does cause hair loss in <3% of women. your part is to figure out if <3% is too big of a risk for you. if it is, totally cool! if it's not, that's equally cool! cos it's up to you.

fondue with cheddar

@MissNelson I hadn't heard this, so I hope it's just a myth. I'm considering the Mirena, and while my hair isn't thin, it is very fine. So thinning hair would be bad for me.

MissNelson

@Lola McClure nice! <3% is totally manageable. Thanks for the info.

fondue with cheddar

@MissNelson I actually came here trying to figure out what "love percent" meant.

cherrispryte

Question for all you lovely IUD-havers, if you're comfortable talking about it: Did your weight fluctuate at all when you got one? I know weight gain is officially not a side effect of HBC, but I call a big ole bullshit on that one.

QtheQuidnunc

@cherrispryte I have a Mirena and any weight fluctuations I've had were due to my shitty diet, lack of exercise and lots of beer. Once I got that together (put my beer budget into pilates classes) I was back in fighting shape in no time.

saul "the bear" berenson

@cherrispryte I haven't gotten an IUD yet, but right now I'm on the nuvaring and, having gone on and off of it a few times over the years, I can definitely say I gain a good 5 pounds when I go on hormonal BC. Plus my libido goes on vacation when I'm on the hormones, so that's not terrific. If you're worried about it, maybe Paraguard?

DrFeelGood

@cherrispryte With paragaurd, I have not experienced any weight gain, I have several friends on it and I don't think they have either.

parallel-lines

@cherrispryte I got a weird band of fat around my lower abdomen, which was somewhere I never really gained weight there ever (I'm a pear, it's the one area of my body that I actually like). Did a little research and apparently I'm not crazy: http://iud-divas.livejournal.com/2416272.html

absofreakinglutely

@cherrispryte No none. No weight gain, no acne, also no period.

oh! valencia

@cherrispryte ditto QtheQuidnunc. I've gained, but pretty sure it's because of all the beer and gravy.

empathicalist

@cherrispryte Yes, definitely gained weight, and the only thing that changed was the Mirena. 40 pounds and brand new high blood pressure later, I figured it out, and pulled the plug. Unfortunately, while UHC covers the insertion and removal, they consider it a 'surgical procedure' so you may have a high deductible/co-pay. $200 for someone to pull on a cord.

gobblegirl

This was delightful! My only reason for rejecting IUDs out of hand is that you can’t skip periods, which is my favourite thing about my Pill. But it seems way cheaper, which is nice…HMMM.

Bebe

@gobblegirl BUT, you might actually just not get periods at all! Or just very, very light ones. (I'm speaking from Mirena experience here, not Paraguard, and that seems different). That was my concern, too, and since getting the Mirena, I have a few days of spotting maybe 3 times a year, and not much else in the way of a period.

amelia!

@gobblegirl I have three friends on Mirena and all three said that after the first few months they completely stopped getting their periods. So yay! Skip 'em all!

the angry little raincloud

I've had a Paragard for about a year and a half now. Insertion was miserable, my periods are way heavier, and I still have issues with cramping, but I wouldn't go back. I love not having to think about it. I love not having to pay for anything anymore. I got it back when I had really good health insurance: the whole thing cost me basically $10 ($5 copay for the visit for the insertion, and $5 for the follow-up). $10 for 10 years, not bad. Suck that Republicans.

Lola P.

@the angry little raincloud yes, suck it! def talk to your provider about a short course of birth control if you're willing--it can really help that bleeding!

Chuck

Yey! I Heart Coil Chat! So much fun.

I have had both type of coil and, oh my gosh, get the Mirena. I had a copper IUD and, while I appreciated its non-pregnancy properties, I had to get it removed after two years because it was just ALL BLEEDING, ALL THE TIME. There was so much blood, it was mega gross. Prior to that coil I had had what I assumed were normal periods, maybe slightly tilted towards the heavy end of the spectrum, but the copper IUD sent them beserk. 10+ days, every 3 weeks, so heavy. Super extra mega plus tampon, 1 hour, BOOM! Full Moon Cup, 2 hours, BOOM! Also, the cramps. Ouch. Eventually had to give up on it.

Has been pretty smooth sailing with the Mirena though. Lighter periods (although definitely still in evidence, Doctor that lied to me), lighter cramps, little by way of side effects. I love it and think everyone should have one. That said, both of my insertions hurt like fuck. My Doctor said that 50% of women feel no pain but at 19 and 21 respectively, pre any kind of baby action, I was not one of those women. Get a coil but (particularly if you are young?) dope yourself up on a bunch of painkillers 30 minutes before and make sure someone is there to help you get home. Do not try and walk home alone afterwards. That was a mistake.

Also, I'm in the UK and both of my IUDs were 100% free. Love you NHS!

Chuck

@Chuck Also, not mentioned in the post, when I had mine inserted they had to use what felt like a car jack to crack my cervix open wide enough for them to pop the IUD in. Just an extra little gory detail there...

timesnewroman

Reading Hairpin's (or any American website's) discussions of medical stuff makes me <3 u NHS SO HARD

frigwiggin

So, if I get one like I kind of want to, it will either be wonderful and birds will sing forever or I will hate it with the fire of a thousand painful suns? I'm scared of pain, you guys. :( (Also, can you use a menstrual cup with an IUD in? I guess as long as you break the seal it wouldn't suction it out...)

Chuck

@figwiggin In my experience there is less long term pain with a Mirena but you have to go through the insertion pain more often. Swings and roundabouts. And, yes, cups are fine. I think it takes more than a light air lock to sucker these bad boys out!

realtalk

@figwiggin I use a cup all the time! makes the cramps better. my insertion wasn't super painful, either.

Ruby

@figwiggin Yeah I use a diva cup with it even though they tell you not to on their website.
Like you said, you just break the seal a little first-like don't just yank it straight out.

Lola P.

@figwiggin @Ruby yup! y'all have it right--break the seal, although i doubt you'd get much suction on the tiny tiny strings even if you didn't. there's nothing in the literature about it that i could find, and i've never heard a story from a patient...

here's the man dr. hatcher himself on it:

Lola P.

@Lola McClure contrary to popular opinion the hairpin hates me. here is the link to robert hatcher saying that diva cups n' IUDs are cool: http://www.managingcontraception.com/qa/questions.php?questi

amelia!

@figwiggin The doc who put mine in said that I couldn't use the Diva Cup with it, BUT when I almost walked out she said "Well, I mean, just don't rip the Diva Cup right out, is all. You know, break the seal." I was a bit concerned that she knows people who actually do that (ouch!), but I scooted back onto that table nonetheless (and I've never been happier)!

Changeling

@figwiggin
I use a Yuuki cup with my paragard, and have had no problems! Other than breaking the seal, make sure that your strings (if they weren't cut short) are curled up somewhere and not dangling into the cup so you could pinch them in there. That's never happened to me, but I read it's a possible issue.

NeverOddOrEven

Another Paraguard Pusher here. Got mine 6 years ago and never looked back. Love it.

But mostly I wanted to say THANK YOU for providing so many resources to fight the ignorance if/when you run into it.
I made the mistake of doing independent research and making up my mind as a stubborn, unmarried, childless, 22 year old single woman and went through at least 5 doctors who all refused. Big ups once again to Planned Parenthood!
My only consolation is that my sister says I changed the family doctor's mind. After he denied me the visit spurred him to look into it more and I guess he realized what an ass he'd been.

dinos

This post is awesome. Thank you so much for a ton of serious research and links to resources and funny koala pictures.

Lola P.

@dinos thank you! it means a lot--this was tough to write. nothing inspiring the ever-constant rowing towards accuracy like (a) a topic where misinformation is the norm and (b) the possibility of an entire internet of people telling you you're wrong

Marzipan

30% of non-baby-having people seems like a non-trivial chance of not having enough uterus-space. Can you address that a little more? I mean, if I go to my doctor, and they say, oh, your uterus is too small, I just, can't have an IUD? At all? That's it? I need to know how prepared for disappointment I should be because I'm so totes psyched on an IUD.

It seems like going to the mechanic, and they tell me all these things are wrong with my car. Sure, they are the expert. But...I don't want it to be true, and I can't really check for myself.

DrFeelGood

@Marzipan I heard that your uterus may be too small line from my Primary Doc, then I went to Planned Parenthood, told them this - they looked at me like I had 3 heads, so I would talk to someone who deals with them a lot. Interesting that they increase to 30% on 2nd insertion though... hmm. I mean the actual devise should theoretically fit in any uterus.

Lola P.

@DrFeelGood hey, i'm not quite sure what you mean by "increase to 30% on 2nd insertion?"

Lola P.

@Marzipan yes! happy to address it. thank you for asking, cos this is interesting to me.

so there's the difference between parous (have-baby) and nulliparous (no-have-baby), which is what the evidence is based on. but more and more there's thinking that it's nulligravida (never been pregnant) that's more likely to have a uterus smaller than 6cm. as in, a first trimester abortion or miscarriage is enough to make the difference, you don't need to have actually BIRTHED ANOTHER UNTO THE WORLD. but i haven't seen any hard statistics on that!

at any rate, they're obviously going to measure your uterus to make sure it's big enough, so there's that. and you got it--if it's too small, it's too small. the mirena people are coming out with a slightly smaller IUD in 2014-ish specifically for those who can't fit one. in the meantime, i would not recommend getting pregnant to make your uterus big enough for an IUD. tempting although it may be!

DrFeelGood

@Lola McClure Oh I was just wondering what the statement "If you get another IUD, there is a 30% chance of having another expulsion: most recommend closer monitoring the second time around." is based on. Why would your chance of expulsion increase? I am nulliparous and nulligravida (i assume) and I have to get mine removed because of perforation issues (it is partially embedded in my uterine wall), and am wondering if I should get another, or a diaphragm.

Lola P.

@DrFeelGood OH! that's a way different situation than normal. i'm sorry that happened to you! your chance of expulsion increases after you've already had an expulsion--without hitting the books my guess is that it just indicates a tendency to expulsion in your body, as opposed to something that actually goes down during the process, since expulsion doesn't really...do...anything to you.

it really depends on your situation and what you want to do. except in extreme cases a perforation doesn't mean you can't get another one, i've read even a month afterwards--let me look this up more and get back to you.

DrFeelGood

@Lola McClure Thanks! So my gyn's office told me that they could insert a new one immediately afterwards, I'm not sure though how deeply embedded it is, my understanding is it is just the end of the arm... I am just dreading the possibility of having to go to the OR to have it removed. What is strange is that none of my doctors has really flat out TOLD me to have it removed, the gyn I saw recently is the only one who "suggested" it, so I am wondering if it is the kind of thing that, since it is causing discomfort, I should have it removed - or if there are other long term implications for having this situation.

This is really helpful though!

Lola P.

@DrFeelGood are the strings still there? if it makes you feel any better, if it comes to surgery, it is a very, very quick and uncomplicated surgery. and hey, if they put it in right after, you're under, right? (tap dancing, bright side of street, everyone shakes their head softly at me, but i just wanna be happy, etc.)

feel free to email me--i am probably not close enough to hold your hand but i can e-hold your hand and i'm good at finding funny kitten pictures.

dj pomegranate

This story is relevant to my interests!

I am going to throw my anecdote into the anecdote hat, too. The stats: 29 y.o., no babies yet, previous miscarriage (they asked me about this, something about the size of cervix? Unsure.) I got my IUD inserted on the last day of my period, which they said made it easier to put in.
1. I got Mirena 6 months ago after being on the pill (orth-tricyclen) for like 7 years.
2. Insertion sucked, it mad me feel woozy all morning, but by the time I got home I was fine. Not chipper, but fine. The next day, no pain at all but still a vague achy feeling (like a sore-muscle feeling.) Periods have basically disappeared at this point, but monthly cramping has remained. in fact, the cramping is slightly worse than when I was on the pill, but not debilitating or anything. The two months or so I felt frequent sort of jabs of aches, like strong, stingy cramps, on a sort of regular basis. Now those are all but gone, leaving only the PMS crampies behind, and those are for like an evening. Also during the first month or two I kept swearing I could FEEL IT IN ME, but I am sure that was psychosomatic. It's weird to think about something chilling in your uterus, right?!
3. Libido is awesome--way better than on the pill. On the pill I had to WORK SO HARD to be interested. Now it's much better and cyclical and I don't have to work at all! Wheee! But still not as good as no-bc.
4. IF YOU ARE IN NYC, there is a free clinic that will give you an IUD for FREE did I mention it is FREE? It is a block W of Union Square--cant remember the name, but if you want I can look it up and post it. I have insurance that doesn't cover any bc, but this was FREE! Also, I had, like, a SUPPORT TEAM of the doctor, her two med school assistants, and a "helper" whose whole job was to hold my hand. Seriously you guys, it was like a reproductive health party up in there.
5. Thank you for this article. Before getting mine, I researched and researched and talked and Googled for WEEKS and my conclusion was basically the same as this article -- but you have put all that together in an easy-to-understand and easy-to-read and also very comprehensive way, and for that I salute you!

tortietabbie

@dj pomegranate I felt the same way about being able to FEEL it. And the damn strings! I asked a nurse to snip them to be shorter because they just felt SO long, but she said any shorter and they'd be dick-stabbers. (Sometimes still my partner will feel them during sex and say, "hey! I just felt your string!" He also calls it an IED.)

That clinic sounds bad ass. It's remarkable how much of an effect just having someone hold your hand can have.

dj pomegranate

@tortietabbie IED lol!

Chuck

@tortietabbie I held the nurse's hand the second time around and it definitely helped. She was very forgiving about my nearly breaking her fingers. I've never had any problems with the strings but the boyf was convinced that eventually a copper resistant super sperm would come along that could outwit the coil and I would have a Transformer baby...

tortietabbie

@Chuck Transformer baby! Oh shit! Instead of boy/girl you'd have to decide if you wanted a car or a blender...

Lola P.

@dj pomegranate thank you dj! and fer your experience. one slight correction, though: every day in the clinic is a reproductive health party

Chuck

@tortietabbie I will take the blender, please. Or perhaps a KitchenAid...

dinos

@dj pomegranate Can you find the name of the clinic?

AmandathePanda

@dj pomegranate I couldn't specifically feel mine, but I did get my abdomen x-rayed recently (dumb doctor thought I was constipated so badly I needed x-ray proof. I wasn't, and knew it.) and I could see it perfectly on the x-ray. It was awesome! I also know it's there if I do a lot of ab work at the gym. I get mild cramps and spotting, and sometimes certain crunches hurt. I've never had kids, and I had a longer than usual adjustment period. My gyno says it's fine and to just take some Advil if it's a problem.

My guy also calls it my IED.

dj pomegranate

@dinos It's 16 E. 16th St, Institute for Family Health. I was referred by my wonderful gyno (Dr. Kearns Stanley, if you're in the market -- she is the best gyno I've ever had, srsly), but I'm not sure if you need a referral to get an appointment. The Yelp reviews are terrible, but my experience was very positive (eta: looks like many of the terrible reviews have to do with the wait period.) The wait in the waiting room is really long, since it's a free clinic and all, so an earlier appt is a good idea. Mine was at like 8 am and I was out of there at about 10:30. But for free five- or ten-year bc, a few hours wait is a-ok.

dinos

@dj pomegranate Thank you! This is very helpful, and I am also in the market for a new gyno.

fondue with cheddar

@Chuck If you get pregnant with a copper IUD and it's a girl, I think you're obligated to name her Penny.

Chuck

@jen325 Aww, Penny would be so cute! That's an amazing idea. (Aside from the increased risk of ectopic pregnancy...)

255
255

@AmandathePanda Seriously abdominally you can feel it? I am a singer so my lower abs are basically my entire mechanism and I work out a lot using my transverse abs.... Am I going to be bleeding all the time with Paraguard?

realtalk

@scazza sofija I didn't bleed all the time. It seems like you're really stressed out! Did you talk to your gyno about whether this was a good fit for you? I think that would be more helpful than coming back to this post, since it's so old. breathe! you'll be ok!

255
255

@realtalk Hey I'm actually fine, but thanks for asking! Maybe I'm just caffeinated? I am not a BC fan at all, and do enjoy not being on anything frankly so this is a significant step that I was led to believe wouldn't change things much. So any system-wide changes are going to concern me.

Generally I just am surprised to read all these horror stories. Have you seen some of the others in these comments? I'm trying to take it with a grain of salt and see part of it as the Hairpin style of discourse, bc the no-poo thread was also full of horror stories and I love no-poo. I had just heard mostly positives, and I'd been eager to get it immediately since my guy and I have been enjoying unprotected sex more than not. Now I am I think reasonably nervous about the side effects that are potentially severe, potentially affecting sex drive and sex quality, when one of the main points for me is to improve sex. I'm not a fan of women having to do all these things to our bodies so maybe it's just my POV you're noticing.

realtalk

@scazza sofija ok good! I think like any other BC method, there are people who love it and people who had really terrible experiences, and the people in the middle are probably not talking as much. When you say you're not a BC fan, do you mean hormonal birth control? I hate (HATE) hormonal birth control, and I adore my Paragard. Since the Paragard is non-hormonal, it shouldn't have system-wide changes, and it shouldn't affect sex drive. But it is a foreign object implanted in your uterus, so it might change some stuff. My period is shorter (went from 4 days + 1 day spotting to 2 days + 1-2 days spotting) but heavier, my cramps are about the same in intensity and still completely manageable with Advil but they feel a little different (shorter and sharper), and as I mentioned in the thread below, it has affected which positions I love and which positions I don't love so much when my cervix is low. I think a certain amount of nervousness is definitely understandable, but I love mine, it's made sex way better for me and my partner (condoms suck and I refuse to be on HBC at all), and I would definitely encourage you to talk to your gyno about it.

And I think ALL of us are right there with you - I'm not sure anyone is a fan of women having to do all these things to our bodies. It's shitty that there's no reversible, effective BC method for men (which is largely because of a lack of funding for research into reversible effective male birth control, which is largely because of misogyny, fuuuuck that). It's terrible and I wish it were different, definitely. But I think the IUD is overall a really good BC option for a lot of women.

255
255

@realtalk Thank you so much for this. Helpful. Giving it a try despite the outlier experiences seems worth it and I'll ask the doc about my questions regarding pain and abdominal changes. I am glad you're with me on hating condoms. I only realized recently how much they suck and I'm addicted.

Killerpants

Baby infection!

Lola's posts make me LOLa. Yea, I said it, and we're all embarrassed for me. No really though, I couldn't love this more if I tried. The pony/dog/koala photo just about killed me.

Lola P.

@Killerpants killerpants, email me. you are the nicest person. i want to like, send you an e-card thanking you for your support.

Killerpants

@Lola McClure Hey wow! No thanks necessary, but done and done, because you're neat.

fabel

<3 the heart/vagina connection you made there. That is all.

Bon Vivant

This is a crazy question, but can you ladies with IUD's and pierced partners weigh in? My guy has a prince Albert (ring, not post), and although I've been wanting an IUD for ages, I'm afraid of it....catching on the string? Or Some other horrifying intertwining not unlike when two kids with braces kiss and get all locked together.
Tell me I'm crazy. Please?

tortietabbie

@Bon Vivant Oh yikes. O.O I can definitely see how that would give you pause.

Bon Vivant

@tortietabbie nightmare fuel, right? :/

Bebe

@Bon Vivant That IS nightmare fuel, indeed. I'm just guessing here, but whether that's possible probably depends on your individual anatomies - like, maybe the doctor can take all your measurements and if you can estimate your guy's length, maybe your doctor will be able to tell you if that's likely? Is that stupid?

fondue with cheddar

@Bon Vivant Wow, good question. If there's a chance of intertwining, that could be BAD. My partner isn't pierced, but I'm still curious about the answer.

oohdarling

Oh, IUD's, I want to love you...but all my real life friends who got one have had NOTHING but terrible experiences. Not just "oh, it was sort of ouchy" but literally passing out in the street from pain, having to get it removed immediately, suffering through two months straight of heavy bleeding, telling me it was worse than labour, etc etc. But then, the internet makes IUD's sound so amazing! I don't know who to believe anymore.

TeresaOtter

Buhh, I'm waffling. Look at me waffle my way through the comments. I really want an IUD because I always forget my birth control pill, and it's so much more cost efficient. I just don't know if it's really right for me? I certainly don't think it's _wrong_ for me. This article has definitely been the most convincing. I'm mostly waffling because I can't look someone in the eyes with one! I am so indecisive, I'm sorry.

I wonder if there's a state-by-state distribution of ladies with IUD's. I feel like Texas has the fewest, which can't possibly be true, but I don't know anyone with an IUD!

saul "the bear" berenson

@TeresaOtter What do you mean, you can't look someone in the eyes with one?

Lola P.

@Moxie @TeresaOtter i'm sorry guys i had to

it's a sickness really

TeresaOtter

@Lola McClure @Moxie Haha, thanks, and now I realize that sounds pretty weird. I want to talk to someone in the flesh about their experience. It's hard to gauge feelings and emotions on the Internet or in an informational packet. I can't speak to someone I actually know and see in person about their experience because I don't know anyone with an IUD. I essentially want to make sad faces at them, someone in person, versus my computer monitor, because I'm a wimp. Seeking validation, I guess.

realtalk

@TeresaOtter guuuuurl if you want to skype about it with a 22yo in california I'm totally down. I love mine but they're def not for everyone.

saul "the bear" berenson

@TeresaOtter Ohh ha - got it! That makes much more sense than how I originally read it! I was picturing some kind of Texan-IUD-shame and getting concerned :)

Mingus_Thurber

@TeresaOtter If you wanna chat about it ear-to-ear, like over Ye Olde Telephone, you're welcome to email me so we can trade numbers. I'm in Texas! I'm at johannebertha at gmail etcetera.

TeresaOtter

@Mingus_Thurber I might take you up on that offer!

Megan@twitter

Wow, I totally had a vasovagal response (almost fainted) immediately after insertion. And here I thought it was just my body's weird-ass response to pain. Thanks for including that info! Although insertion was somewhat unpleasant, and I had heavy painful periods for the first couple of months, three years later I ♥ my Paragard IUD.

amelia!

@Megan@twitter I am SO GLAD to know that I don't just have a weird-ass body! When the doctor inserted the sound I started sweating and thought I was going to hurl and had waves of blackness and it was terrible. Vasovagal response!

acid burn

So I looked at that thing about pain-reduction and I just wanted to c/p this tidbit: "Misoprostol, a drug to soften and open the cervix, did not help to reduce pain during IUD insertion in women who had never given birth before. However, the study was not focused on women's pain, but rather the ease of placing the IUD from the provider's perspective."
and also say that my [nulliparous] first Mirena insertion was hellishly painful and awful and she tried for MINUTES to shove it up in there while I sobbed and gritted my teeth, and then the stupid thing immediately popped right back out as soon as she removed the tube. But the next week when I came back after taking misoprostol beforehand, and they did a local anesthetic, it was EASY LIKE [very slightly crampy] PIE. So, despite that study, based on my anecdotal evidence, I would recommend that if your insurance covers it, you ask for those two things. Because maybe it was all in my dumb lady head, but they really made a huge difference in my insertion.

Bebe

@acid burn I'm sorry the first attempt was so rough for you! I am also nulliparous (new word of the week!), and a huge wimp. During my insertion, I tensed up and let out a little "eep!" when the doctor got to my cervix, so she very kindly stopped and gave me a topical anesthetic to numb it. It hurt like hell for about 5 seconds, and then it was over. They told me to take some Advil about an hour before the appointment, which I didn't do, though I'm not sure it would have helped.

acid burn

@Bebe Oh, it was okay! I mean, it sucked for a short while, but after the second attempt was successful everything's been fine! It's been, like, eight months or something? I get little twingy cramps sometimes but mostly I forget it's even there. And after 15 years of horrible, curled-up-on-the-bathroom-floor periods, I now get an extremely low-key period for like one day max? Like I don't really even need to use tampons anymore.

I'm glad yours went okay, too!

basement cat

Love my ParaGard! Had a rough insertion (apparently I have a tilted uterus??) and the first 6 months or so were quite the crampy adjustment...but it's been almost 2 years now and it's awesome- I never have to worry about accidental babies. It's like I just had to get reacquainted with my period, if that makes sense. My bf can feel the strings sometimes but he says it isn't painful- just can tell they're there.

Danzig!

My bestie has the copper kind and on several occasions we've gone out and she's had to stop what we're doing and sit down for awhile because of the pain. She's a trooper and she's taking the bad with the good, but that seems rough (on balance, probably one of the lesser rough parts of being a woman, but). I mean, I'm a boy but I've had kidney stones and the surgery for that condition involves inserting a hard plastic stint into your bladder for about a week.

Now, I don't imagine the two are much alike (the male urethra is significantly less suited to having things inserted into it than the vaginal canal / cervix, to say the least) but 8 years later I still reflexively seize up when thinking about foreign objects poking the inside of internal organs (it was a sharp stabbing pain that caused bladder spasms, which triggered long drawn out cycles of pain). And I WAS passing thick coagulated blood through the stint, which is sort of like a period, sort of? It was literally the worst experience I have ever had in my life and I wanted to die. Don't get kidney stones, people. Never. But get IUDs if they serve you! My bestie does speak well of it even when she's doubled over on a park bench. And she has all kinds of crazy stress-free sex, which is probably worth it!

Sea Ermine

@Danzig! I think it's like hormonal birth control pills in the sense that some people have a lovely time with them and other people have a lot of problems afterwards. While I haven't had my copper IUD for long so far (aside from the day of insertion) it has been pain free and I've heard of a lot of people who don't even notice it's there unless they are checking their strings. And of course then their are people like your friend. The main issue with the IUD is that since for a lot of people it's more expensive so it's harder to pony up that much money just to have it pulled a couple months later because it doesn't work for your body, but I think the solution to that is to try and find somewhere where you can get it for less (via the links above) so that way it's not such a big deal if it needs to be removed in order to switch for something else.

KikiCollins

Another glowing review for ParaGaurd!
I decided that after twelve years of pills, shots and rings I wanted to take a break from hormones for a while- but I'm also lazy and like to have sex.
I did want to get permanently sterilized, but my state has a reproductive health program for low-income women that is my only way to affording pap smears and if I got my tubes tied I wouldn't be eligible for it anymore. So hey, this is the next best thing!

The insertion hurt pretty bad, I won't lie, but it was quick. I was pretty crampy for a few days after that, but nothing a hot water bottle, a vicodin, and curling up to watch movies didn't fix. My periods are heavier, but they were very light to begin with so they're perfectly manageable even now.

And it was all free, thanks to Planned Parenthood and the aforementioned state program!
So if you can't afford one, move to Washington! :P

Carrie_Grasshopper

I was really excited to read about Teva's other effective non-hormonal birth control methods until I clicked on the hyper link and then became sad.

TARDIStime

@Carrie_Grasshopper I laughed!

Sea Ermine

Just a question, have any of you fellow IUD havers had experience's with the strings poking your partner and if so what did you do about it? I got my IUD put in last tuesday and so far everything has been lovely but the two times I attempted to have vaginal intercourse I had to stop because my boyfriend said something was stabbing him (he said it felt like the end of a paper clip but thinner and pointier). The first time it was in the middle of sex and the second time it was right at the beginning, first thing. The gynecologist who inserted mine said that she left them longer (and would trim them at my 6 week visit) so I thought getting them cut shorter would help but then I heard that shorter strings tend to poke more so I'm worried it would make it worse. Have any of you had this problem and then solved it?

philomene

@Sea Ermine You get the strings shortened at the 6 week check up to see that its going ok

LilyMarlene

@Sea Ermine Paragard user here. My partner has always noticed the string, and has described it as feeling like "that second before you get a paper cut", but hasn't minded overall. During our last few encounters, my partner has jumped off me in shock and screamed "IT CRAWLED UP MY COCK!" I've had my Paragard for four years now, so apparently something has changed? Is it angry? Is this Phase II of its birth control technique - fight off all the sperms at the source with its tentacles? I dunno. But a visit to resolve this is also in order.

fondue with cheddar

@Sea Ermine Someone in an above comment said they had the pokey problem at first but that the strings softened over time.

KikiCollins

@Sea Ermine Mr. Collins said it was pretty stiff at first, and that he could definitely feel it poking him when we had sex.
However, around the time I had it trimmed at the check-up it had softened up considerably, and ever since he said he can hardly feel it. So be patient, it's likely that all you need is time.

QtheQuidnunc

@Sea Ermine Well my partner did experience poking initially and I had them slightly shortened at my 6-week check-up. But both my physician assistant (who put it in) and the nurse who did my check up cautioned me against having the strings cut too short which they said some doctors do. If the strings are long enough, they'll soften and wrap like KikiCollins said, if they're too short they can't wrap around and you'll have a prickly cervix.

Jon Custer

So those failure rate stats, are they per-use? Per average lifetime period of use (in which case, how long is that?)? Per year?

Because I've just realized (to my horror), even with a 0.8% failure rate PER USE, if you're having sex, say, 5 times a week, then the lady will get knocked up every six months or so on average!

(My math is probably wrong, but in case it is not, please don't let the Republican Party know.)

Lola P.

@Jon Custer omg those are for the first year! as in, less than 1 woman in 1,000 will get pregnant using the IUD in the first year. i believe the rates go down after that, as well--so even more effective.

man. that would be terrifying. "baby, i'm in the mood but--i don't know. it's been ten times this week...we're about to hit 8%."

Jon Custer

@Lola McClure So no sex rationing necessary? Thank god.

j. preposterice

@Jon Custer yeah. % failure rates are calculated per 100 women per year, usually. So something with a 10% failure rate means that on average, 10 out of 100 women who used that method for a year would get knocked up.

C_Webb

Only downside to my Paraguard is when the string disappears and the OB has to go looking for it to make sure it's still there. Um ... how big is my uterus that something could get lost?

BTW, as I mentioned upthread, I'm due for a new one and all these insertion horror stories have made my uterus crawl back up behind my spine. I can feel my cervix sealing itself.

Ophelia

@C_Webb Open the airlock doors, Hal.

philomene

I just wanted to state my undying love for Mirena. I have had it in twice. Each time my periods have disappeared by two months out, so I am always ready for sex and when I had it out to have a baby I was pregnant in two months and I didn't even really try that hard. Also, the second time I felt zero pain as my gyno had told me to come in with a full bladder. somehow it straightens something out up in there. I have no idea, but the first time it was really strong cramping for 20 minutes afterward. But I love not having periods and I love not having to remember to take a pill. Somehow, I couldn't remember to take it after I had kids (sleep deprivation?). I am such an evangelist I have gotten 5 friends to use it. And the progesterone did nothing to me.

AmandathePanda

So, can we talk about discharge? Because I have a Mirena (about a year and a half now) and I TOTALLY have that vaguely-like-a-yeast-infection discharge and I hate it. (I currently HAVE a yeast infection because I am a twit and wore sweaty running leggings for hours but whatever). It's um...sorry, gross..but more snot-like than yeast-clumpy though? Definitely has an odor, and is definitely more there than previously, and I definitely don't like it. HALP.

paper bag princess

@AmandathePanda I've had Mirena for about a year and I definitely noticed a change too! Mine smells ....weird. Different, at least. But I don't think the texture has really changed. I think for about the first six months the different smell was more noticeable, but lately it's normalized? I do notice different smells at different points during my cycle but I'm always too lazy to keep track of it.

vivian darkbloom

@lizzle @AmandathePanda I totally noticed the change in smell but it seems like such a weird thing that I thought maybe I was crazy? It's not bad just different, especially post-sex. I figure it's my cyborg uterus shooting sperm with some crazy no-baby ray gun.

Lola P.

@AmandathePanda hello! There’s evidence of a connection between yeast infections and IUDs but it's small, like 1%. so my first thought was that it could have been because you've stopped using condoms: semen can raise the pH of your vagina, which can cause yeast infections if you’re sensitive.

more: the main action of the progestin in the Mirena is to thicken cervical mucus so sperm can’t get in, so many people notice a benign increase in vaginal discharge that's more snotty. this seems even more likely when you told me the discharge happens cyclically...does that make sense?

Lola P.

@AmandathePanda here's some more about it: http://www.managingcontraception.com/qa/questions.php?questi

fondue with cheddar

@Lola McClure I'm not on hormonal birth control, but I get snotty discharge sometimes. I always assumed it was from a mild infection (no itchiness, smell, or pain), and it always clears up when I ovulate or get my period. (Without getting too graphic, let's just say I've got structural issues that make it easy to get an infection.) But based on what you're saying, it sounds like it could just be a normal cyclical thing. Could it?

Lola P.

@jen325 yes! very much sounds like it. although this is written for people trying to conceive, the descriptions of cervical mucus throughout the cycle are applicable to everyone with a cervix: http://ibabydust.com/cervical.asp (also, i can't with "ibabydust.com")

Lola P.

@Lola McClure where in the hell does "dust" come into the picture i mean honestly

fondue with cheddar

@Lola McClure Wow, that was so informative, thanks! You're the best.

And I really have no idea what dust has to do with babies or fertility. I know it's hard to find a domain name that hasn't been taken these days, but really—couldn't they have done better than that?

saul "the bear" berenson

@AmandathePanda A reference to His Dark Materials, perhaps?


anyone? yeah probably not.

absofreakinglutely

Things that make IUD insertion better: 1. Vodka screwdriver before doc. appt. 2. Valium.
Seriously, when I balked the first time I went in for my Mirena, my doc offered to write me a prescription for a couple pills to chill me out for the next time. Love her!
Now, 2 years later...it's OK. Yes, I still have it, but I think it's interfered with my sex life. I feel it, my ltr bf feels it...sometimes it just HURTS after sex (not always, but sometimes). But the advantages are huge, not having to remember/take (and pay for!) a pill everyday, my periods are practically nada. So...I don't know. I have a gyno appt coming up, a serious heart-to-heart with my doc is on the agenda.

Kirsten Hey@facebook

I had a paragard fitted last June. I wish I'd done it 20 years ago. Fitting was painless (I haven't had children) and although my periods are longer now they're not more painful. I love it.

Kirsten Hey@facebook

Update - I changed my paragard to a mirena last week because I got fed up of 10-12 day periods. Fitting was a bit painful because I hadn't taken any painkillers before I went, but it was literally 5 seconds of moderate discomfort followed by 20 minutes of period-pain-like cramps, which had disappeared by the time I'd walked to the nearest cafe, where I had a cardamom hot chocolate and a chocolate cake.

redkite

I had the Paragard for a year and then had it removed. I got it for free from Planned Parenthood of Greater Iowa, which was amazing. Insertion, as others have said, was really painful but very quick. I experienced some cramping the first few days I had it but the 800mg ibuprofen pills from Planned Parenthood took care of the pain. Unfortunately, my periods were so painful and heavy and long that I ended up having it removed. I would bleed through a regular tampon in 30-60 minutes, the cramps were blinding, I had cold sweats and nausea, and I ruined all of my underwear from breakthrough bleeding which was also quite heavy. My pre-Paragard periods were not light, but certainly manageable with a regular tampon changed every 6 hours or so, and lasted around 5 days. My Paragard periods lasted between 9 and 14 days, all of which had very heavy flow.

I really wanted to like it! But I was just so miserable and sick every three weeks, and in a sexual relationship with someone who wasn't crazy about period sex, so I cut my losses and had it removed. Even sticking it out for a full year was probably too long; every month my roommate tried to convince me that it wasn't getting better. I felt instant relief when my OB removed it (easy as pie, too!), but that could have just been psychosomatic. Two years later, my periods are still a little heavier than pre-IUD, but so much more manageable.

That said, I'm still a big fan! I know for many women it is an excellent choice, and I'm bummed it didn't work out for me. I would never discourage anyone from getting it, but I think it's important to know that sometimes it doesn't work out. I'm going to look into if my insurance covers Mirena, especially now that I quit smoking...

paper bag princess

Just wanted to add my anecdote! I've had Mirena for a year and I LOOOVE IT. I'm definitely one of those ladies in the commercial who will talk about it to anyone that will listen.
I was 25, no kids or previous pregnancies. I'd also never taken any HBC before so I was a little worried about introducing the hormones, but I've seen no difference.

My insurance (Kaiser) covered it 100%. I was going for my annual with a new doc so I had assumed I'd have to make a followup appt for the actual insertion, but she said "oh, do you want it right now?" and pulled a Mirena box out of the cabinet. The actual insertion was just fine and I went to work after and out for drinks that night. I did have lots of pain and spotting for about 6 weeks, but I pushed through and it got better. The cramps weren't the sort of dull ache I'd had before, but more like a sharp pinch. I still sometimes get the pinchy pain once or twice during my cycle but it honestly only lasts for 5-10 seconds.

ALSO, the doc said that insertion was a breeze because my uterus is a "straight-shooter." That's one of the best compliments I've ever gotten and I will repeat this to people if I'm drunk enough when I tell them about it!

tallulah

Hi, I registered to post this because I feel so strongly about IUDs. I am another person who sounds like I'm on the Teva payroll and have to stop myself from urging every woman I know to go get an IUD ASAP.

My background:
31 years old. No babies ever. No history of lady part complications/problems, like PID etc.

1. I am the 17%. I didn't think it would hurt so bad and it HURT. SO. BAD. I was screaming in pain. It hurt so bad, that if I ever give birth, fuck epidurals, I'm asking for twilight sedation. I self-treated post-appointment with a vodka cran and lots of ibuprofen. I felt like shit for a day or two afterwards. I took generic Cytotec beforehand (to "soften my cervix"), which might have made things worse. Or, maybe things would have been worse with out it, because of my abnormally small, hard cervix. Who know? Anyway, I am a big baby and that shit hurt. My cramps are worse than they use to be, but bearable, and I'm hoping they'll settle down in a few months.

2. It was totally worth it. I love that the Paraguard doesn't completely shut down my sex drive, like the pills used to. I love that I can have sex without having that anxiety that I've screwed up my pill-taking regimen nagging at me. I also tell people that my vagina is now Republican-Proof. It's like, go ahead and ban birth control; I am SET for the next 10 years. What are you gonna do, fuckers? Allocate millions of dollars in government funding to provide training, lodging, and transportation for an army of nurses to check for and yank the UIDs out of every non-pregnant woman of child-bearing age? Yeah, right.

3. Do you live in chicago? Chicago Women's Health center. http://www.chicagowomenshealthcenter.org/ Go there go there go there. They are a treasure and we are SO LUCKY to have them. If you don't have insurance--or if your insurance doesn't cover BC--they will help you find a way to get an UID that is in your budget. "You" includes people who have too high of an income to qualify for assistance, but still don't have the extra $$$$ upfront you need for an IUD just lying around. They have docs experienced in insertion and are very supportive of UIDs. In fact, my doc there recommended it. When I was busy freaking out in pain, they also had a very nice UID doula woman, to hold my hand while I screamed.

255
255

@tallulah How is your sex drive on Paraguard? It mildly affects it or not at all? or just compared to pill BC?

j. preposterice

So, I had a Mirena inserted about a month ago. The spotting has been annoying, and it gave me constant. low. backache. for so long that they sent me for my fun transvaginal ultrasound to check its placement. That's eased off now, and the spotting is lessening. I like that I don't have to think about my bc. It was covered except for a $30 copay, which I could pay with my flex-spending account, so out of pocket cost was $0. I had it put in at my postpartum visit (2nd kid) and it hurt like the dickens going in (actually, I think the uterine sounding is what hurt).

That said, the strings poke my husband in his junk, sometimes quite painfully. They're supposed to get softer over time, but if this keeps up I'm going to have to go back to my midwife and see if she can trim them shorter or something. After the last time it happened I checked the strings myself and one of them is...like...sharp and pokey. I hope that resolves.

paper bag princess

@j. preposterice My Mirena strings definitely softened over time and they sort of curled around my cervix, so the ends are tucked away. I'd guess that cutting them too short might make it worse if they can't curl up? I didn't notice how long that took for mine because I didn't have a partner when I got it, but it was probably longer than a month. Maybe two? I dunno...sorry i'm not being very helpful!

QtheQuidnunc

@lizzle Yeah the nurse that did my check up told me that too short is bad and that's exactly what happens, they can't curl up once they soften. I was in a long distance relationship when I got mine but I think it took about 6-8 weeks.

Daisy Razor

Late to the party, but chiming in with some Mirena-love. I had a pulmonary embolism and couldn't take hormonal birth control, and I also had debilitating cramps. I had the Mirena inserted two months after my daughter was born and I haven't had a period since. I know everyone responds differently, but for me, going from two days a month where I'd have to take 4 Advil at work and pray I didn't pass out before they kicked in to no pain at all was close to miraculous.

snuffleupagus

Lola, So relevant to my interests! I'm getting the Mirena in tomorrow because I have migraine with aura and my doctor keeps yelling at me to get off the hormonal birth control (something about HER being the "expert" at this stuff or something). I'm glad to hear so many varied views on it, but I'm a little nervous about the mind-blowing pain/cramps.

I can haz internet hugs, plz?

vivian darkbloom

@snuffleupagus I have migraine with aura which is part of the reason I got a Mirena so you have ALL MY SYMPATHIES!

Porn Peddler

The horror stories about IUD pregnancies and also this "abstain from sex for 2-3 weeks before insertion"

My curiosity about the IUD is officially dead. No thank you.

Lola P.

@Third Wave Housewife that's totally fair--everyone has different dealbreakers, even if having a pregnancy with an IUD is ridiculously rare, i know a bunch of patients who could not feel comfortable with even the smallest percentage chance.

but please keep in mind that all and sundry sex can happen pretty much until we need that room unoccupied to place it if you're on a good method (pretty much any method 'sides condoms) and then you have 5-10+ years to enjoy.

realtalk

@Third Wave Housewife I took that as "abstain from unprotected sex for 2-3 weeks before insertion". I definitely had a lot of sex, just doubled up on condoms and the pill...

Porn Peddler

@realtalk See, I double up on two "not good" methods, I think? Three I guess. I'm pretty secure with what I'm doing (also, I was mostly kidding because the thought of going 2-3 weeks without sex is so sad, and like I said, I feel pretty secure doing what I do now.)

Until I'm old enough to get the Essure procedure.....meh.

solidgold

I am firmly in the <3 u IUD camp. I've had my Mirena for just over a year and I think it's great. I haven't gotten a period in months, which would probably freak some gals out but I love it. I am totally in the 17% though as I had horrible fiery cramps starting with the insertion that lasted about a week. AND my insurance paid for 100% of it, I didn't even have a co-pay for the office visit (thank you Cigna).

A question for other Mirena-havers (and maybe Lola): is there a connection between the Mirena and cystic acne? I have had pretty clear skin all of my life, and then in the last year, boom, big old acne cysts every month or so. Just curious if they are at all related.

Lola, great piece. Thank you!

george glass

@solidgold OH GOD MAYBE, I never put the two together! Same here. Cripes.

you're a kitty!

@solidgold Yep, I had that and so did three of my friends. It wasn't clear if it was actually the Mirena, though, or just our normal skins after going off estrogen-based birth control. One of my friends cleared hers up with topical meds, one with a supplemental HBC, and I've been using spiranolactone (a once-a-day pill). Ask your doctor, there's some kind of solution that'll work for you.

Sparrow Morgan@facebook

@solidgold I got nasty acne for about a month after going off the pill too, so it could be that, and not the IUD?

george glass

Reading about all of your costs: how did my Mirena, inserted 3 years ago when I had both insurance and a good job to pay for the rest of it, end up costing me $1500?! Because that is how much it cost, after insertion fees.
It was SO worth it, because it is awesome and I never ever have to think about birth control, but it was certainly a lot of dollars.

Raquelitamn

I love my little T-shaped bastard. -Have had Mirena for about 2 1/2 years with pretty much no issues.
-I was afraid to sneeze for about a month afterwards - I was sure I would accidentally projectile shoot it out from my vag. But I didn't!
-Hurt like an ABSOLUTE motherfucker getting it inserted. But totally worth the week of tenderness for 5 years of maintenance-free no baby zoning.
-STRINGS - They soften over time. If you cut them too short they may always be poky. If you leave them long they naturally kinda wrap up and out of the way. Give it a little time.
-Ladies with different discharge or smell - There is a slightly higher risk of BV - (Bacterial vaginosis, a smelly cousin to the yeast infection) because the bacteria can live on the strings. I totally got that but then cleared it right up with some antibiotics. Ask your doc!

likethestore

This is so great and helpful! I've always thought the copper IUD would be the way to go once I'm in a longterm relationship (if that ever happens, hahahaha sob).

Ashley Pollock@facebook

@likethestore While i realize the failure rate is low, I am one of that few percent that got pregnant on the copper IUD, i had it put in in october 2010, last april i got pregnant and I now have an 8week old baby boy. Honestly, I have also heard from a few other people that have gotten pregnant on the IUD. Implanon i hear is even better and even lower chances of pregnancy.

you're a kitty!

This is the best article — incredibly informative, clear, and hilarious. Thank you so much for putting in the time to write it, it's going to be sent to a lot of friends for many years. (Mirena yr. 3 and loving it).

Merritt Olson

Thank you for this! I have been preaching the IUD gospel for years to my girlfriends and this is the most comprehensive, clear and well written article I've seen! Cheers!!

Ashley Pollock@facebook

Seriously, anyone who is thinking of getting IUD, read anything and everything you can!! I got pregnant on the Paragaurd IUD 16 months after having it inserted in, i now have an 8 week old baby. seriously, theres been others too. do alot of research. my moms good friend got pregnant with twins on the Mirena IUD. the arm implant Implanon is actually even better I just got one in last week.

Cupcake Coven

Thank you for this great article! It's clear and concise. I'm picking up what you're laying down.

I would absolutely get a Mirena. I'm on Microgestin, third Pill I've tried, and it's ok. I always remember to take it, though not always at the same time of day. My emotions are pretty good, sex drive is pretty good, and it evens out my PMS, thank goddess.

<3 u, hormones!

That being said, I would love a form of BC I didn't have to think about. But I am incredibly sensitive to things touching me. Jewelry, bras, shoes, and waistbands all have to GET OFF ME NOW at some point in the day. This is inside and out. I only wear tampons if I'm swimming. I tried the NuvaRing, and got through 24 hours with it. I felt like I had a Tupperware lid inside my vagina.

So I'm just afraid I would feel Ms. Mirena doin' her thing all day, every day.

Or maybe it's just what I've always dreamed of? How can I know without spending all my dollars?

saul "the bear" berenson

@Cupcake Coven It sounds like you really can't feel the device inside you, at all. But if you're psyched out by other stuff like nuvaring, it might be just the thought of it being inside you that would make you FEEL like you can feel it.

Sparrow Morgan@facebook

@Cupcake Coven Maybe get your doctor to prescribe you a short course of as-needed valium. I used to have this weird AUGH MY NECKLACES ARE STRANGLING ME feeling that had lasted for, oh IDK, five years, and seemed to have started when I began taking Lexapro? Anyway, my doc prescribed me valium for anxiety, and after a little while of taking it a couple times a week, I noticed I could wear necklaces again. The brain is a strange thing that way.

Also I could totally feel my NuvaRing, but it did not bother me that much. My BF at the time thought it felt weird though, so you are not alone.

Cupcake Coven

@Moxie Ah, it's definitely physical, not psychological. I have some widespread nerve pain that makes me super-sensitive to the touch sometimes. So maybe this isn't for me.

Cupcake Coven

@Sparrow Morgan@facebook Not only could I feel the NuvaRing, it was pretty much popping out of me! Hence the Tupperware-lid feeling.

chevyvan

Just chiming in with my experience. I have a Paragard/copper IUD. Never been pregnant. I was on the pill for 10+ years. It made my boobs huge. I didn't want hormonal bc anymore. I am really not okay with winging my bc...condoms aren't good enough by themselves. My gyno told me that the Paragard was the way to go. It was very reassuring to have a pro-IUD doc. I have a background in fertility and family health research and know how widely used they are in the rest of the world. This indicated to me that doc knew her stuff.

Bottom line: I'm glad I got it, but it has not been smooth sailing for me and my copper baby.

I had a failed insertion attempt. It really hurt. My period had ended early (your supposed to be on your period during insertion), and my cervix tightened up. I went back the next month and took misoprostol to soften the cervix. The insertion itself barely hurt at all. I had mad cramps, but nothing I couldn't live with.

My insurance (Blue Cross Blue Shield) covered everything...even the 2nd insertion.

My first period with the Paragard was completely insane. My doc told me if I bled any more than I was bleeding, I'd need to go to the emergency room. The next month was not as bad. Now I take 3 ibuprofen every 8 hours and a vitamin E supplement during my period. That has helped cut down the bleeding. After about 6 months, it's heavy, but very manageable.

A couple months after I got my IUD, I developed a really painful infection in my uterus. I had to go to the doc about 5 times and do 2 courses of antibiotics. I had to take Norco for the pain. It was not an STI. Although I cannot say with 100% certainty, it was probably my IUD that caused the infection. If the 2nd round of antibiotics hadn't worked, I would have had it taken out.

Here's the good part: No hormones. No pills to remember. My boyfriend and I have discussed getting tested so we don't have to use condoms. My sex drive is back. Sex actually feels better than when I was on the pill. For now, I'm keeping it in, but I was *thisclose* to having it removed. Hopefully, things will be better from here on out. If anyone needs the names of some pro-IUD docs in Chicago, let me know.

Sparrow Morgan@facebook

@chevyvan Get tested. There's no reason not to, and knowing for sure makes you feel better.

chillary

Bravo! Everything here is so well covered! I wish I had found this before I got my IUD, but now I am oh-so-pleased that I made the right choice and got one! Hooray everyone!

teebs

Excellent post!

I love my IUD because I like having the freedom of not worrying about taking the pill. However, I am in the camp of folks whose insertion was a NIGHTMARE. I am a pretty tough chick when it comes to pain, and the insertion of my IUD was seriously the worst pain I have ever experienced, and I had intense cramp-like pain for a couple weeks after, as well as bleeding for two months after. I got it inserted two weeks before my wedding (because my insurance was about to end) and I bled all through my honeymoon and had very little sex because it hurt. (TMI time with teebs)

At the time I had BlueCross, and while the device was covered, I had to pay for it initially to be reimbursed later which meant that I had to dig up $580 to pay for it.

While I love the freedom of the Mirena, the pain was so awful that I really don't know if I will do it again when it's time to take this one out. And I'm honestly more scared of childbirth now because if I couldn't handle that tiny little thing, what will a baby do to me?

little_boxes

SO glad you posted this because I have been debating an IUD for a very long time but am traveling/moving constantly right now and haven't had a chance to talk to my *good* gyno (fun fact:my ex-bfs mother) in a while. 2 questions: 1) my (current) bfs mother, who is a nurse (it seems I'm attracted to men with smart moms, HELL YES) has witnessed me go through several periods (which for me has always involved a day or two of fetal-position, crying-on-the-bathroom-floor cramps) and is pretty sure I have endometriosis. I don't want the laparoscopic whatever to diagnose so would like to operate under the assumption that this is correct. 2) my boyfriend is like, alarmingly well-endowed. I use Nuva-ring now, and he always pokes it, sometimes skewers it jousting-style and emerges accessorized (tmi?). How would these variables affect IUD use, anyone?

Changeling

Man, I need an emergency bird hood with which to blind/confuse terrible people who talk to me.

Two-Headed Girl

Laaaate to this party, but I just want to sing the praises of my lil copper buddy (he goes by the name of Copernicus), who's been my BFF for about a year this month. I can't do hormones, and don't feel at all comfortable with only using condoms, so once it became apparent that my boyfriend was awesome and regular sex was going to be a thing, I just went for it. It was iffy during insertion (my GP did it, and she wasn't sure my cervix would be big enough), and I walked around for like a month afterwards convinced that it was going to fall out after every step, but otherwise, it's been great.

I have the Nova-T (Canadian Paraguard), and it wasn't cheap (provincial insurance didn't cover it, and neither would either of my parents' employers' plans, which I would like to point out *would* cover breast implants), but, you know, neither are a year's worth of condoms and a couple of doses of Plan B, so there's that. And my period has actually remained pretty light; I have one super heavy day in the middle, but the rest is just like...heavy spotting.

Basically I cannot fully describe how awesome my buddy is. IUD IUD IUD!

Serafina

@Two-Headed Girl My friend named her Maine Coon Copernicus. I'll, uh, keep the visual to myself.

amelia!

@Serafina As a Maine Coon owner, um, I CAN'T. Currently imagining my big sweet dumb kitty inside a uterus. Ow.

Diana

Can somebody who has gone through both procedures say how this procedure compares pain-wise to a first term abortion? Because the abortion was like, okay, and I really wanted to have an IUD inserted while they were in there but I didn't have the money for both procedures at the time. But I'm having trouble figuring out what CAUSES the pain. Is it the pain of softening and opening the cervix? Is it something to do with the nature of the IUD itself? I'm trying to figure out, if I had a standard surgical abortion and the pain was like, a 4.5ish, how predictive would that be of my pain at the insertion of an IUD? I've been considering an IUD for years but the horror stories! Oof.

lurkypinner

@Diana having done both, I would say if 1st trimester surgical abortion is a 4.5, IUD is a 3, and much shorter. Could be less painful because the cervix has already been opened once? It also should only take a few seconds to pop the IUD in. I have, however experienced increased cramping around my period and ovulation ever since getting the paragaurd 4 years ago, so that's a consideration. But it sure beats getting pregnant again or putting unnecessary hormones in my body...

pedgehog

Ok I love my IUD and highly recommend it; it is maybe my favourite thing ever. But my insertion was HORRIBLE, mostly due to my effed up (well, unusual) lady parts. Wanna read about it? http://antichoiceantiawesome.blogspot.com/2011/02/iud-insertion-my-garbage-nightmare.html

Serafina

Is it possible for vasovagal syncope to be triggered just by being on one's period? Almost every month, roughly 4 to 8 hours after the first sign of bleeding, those exact same symptoms hit for roughly an hour or two.. while I writhe in pain or just lay there naked and overheating on the bathroom floor and debating calling for an ambulance to take me to the ER or /whatever/ just make it feel better pleeheeheeeaaase.

Sparrow Morgan@facebook

@Serafina I am not a doctor!

...but I too have a lot of weird issues that nobody can explain, and my response to things that are strange, but do not seem life-threatening (only you can make that call) is to just treat the symptoms.

Take some ibuprofen as soon as you start bleeding (before the misery hits, because waiting will just leave you in pain for longer), get yourself a cool cloth to put on your face or neck, get a glass of water with a straw, put on some music, turn on the fan and and lay on top of the sheets while you just wait it out.

birdbone

I'm getting a copper T in the morning! I'll let you know how it goes!

birdbone

@birdbone Easy! No big deal at all, I could do that again tomorrow. Before I went in I went and got a massage, ate lunch, took a bunch of ibprophen and it was totally fine. I was a little pale and shaky for a little bit afterwards, but they brought me a bottle of water and then I drove myself home. For me it was super easy, I'm sorry that it can't be that way for everyone. Hopefully I can stay friends with my new IUD for a long time

KiraShea

I'm a nursing student 3 months from graduating and therefore super burnt out but you got me SO PUMPED UP ON BEING AN AWESOME NURSE! Thank you!

AliGator

OK, so I'm waaaaaay late to this party, but I have to say that I have a Mirena and I love it. LOVE. I'm actually on my third Mirena. I'm one of the lucky ones whose period stopped, so I've had 10+ years of no menstruation.

I've had two kids, and my OB-GYN suggested an IUD, since at the time I didn't know if I wanted another child, but I really didn't want to take the Pill anymore. (I also have to say that I was living in France at the time, which may explain why I've been using the Mirena for so long.) I got a fully-reimbursed IUD which made my periods really heavy, and three months later, I told the OB-GYN to get it out of me. She suggested the Mirena, which has been wonderful. (Even not reimbursed, it didn't cost that much.)

My insurance (Anthem) covered the cost of this last Mirena (I had the first two inserted in France). I have a high deductible with no co-pay, and I haven't received a bill for the Mirena, and it's been about 8 months since I had the procedure done. So, WOO-HOO for that!

This is the first time I've posted publicly about having an IUD. Usually I tell my friends about it in private. Thank you, Lola, for putting this information out there.

Feminist Killjoy

"Chlamydia does the crime, the IUD does the time"

thank you for this very hairpinny, very informative article!

amelia!

I'm a major IUD evangelist.

I chose ParaGard 'cause all the data I could find said that Lamictal and hormonal BC impact each other in terrible ways. Anecdotally, I'd noticed a pretty big mood drop when I started on HBC while on Lamictal.

So: copper IUD! Yes, it hurts getting it inserted (like crazy). Yes, I mainline ibuprofen once a month. Yes, it was fucking stupid expensive without insurance. But oh my god, I don't worry about pregnancy anymore and I don't freak out about my brain as much and I think I'm more "in tune" with my body's "natural rhythms" as a result.

Bottom line: best decision I've ever made. Thanks, Planned Parenthood! And thanks, grandparents-whose-monetary-Christmas-gift-made-this-a-reality! I'll never tell you!

lizaboots

@amelia! Thanks for this! I'm on Lamictal too. I tried HBC a few years back and was not-getting-out-of-bed depressed for awhile before a light bulb went off and I tossed the pill. (After which I rapidly recovered.) I do miss the condomless sex, though. Perhaps ParaGard is the answer for me!

Wombat

I have a Gynefix! It's a European type that is basically fishing wire with copper beads on it, so it's flexible and non-pokey, and theoretically causes less pain and heavy period bleeding as a result, and is also better for nulliparous women. Although I'm not sure if that's actually true. But I made a special trip to Belgium to get it while I was in Europe 4 years ago, so I pretend that it's true to justify it? Anyway it's the best ever and I highly recommend it. And insertion hardly hurt, although I did get topical anesthetic so maybe that's why. Gynefix!

maggie g

Thank you so much for this post!! I've been half-heartedly researching IUDs as an option for months, and this amazing, readable, and comprehensive explanation has given me renewed interest in actually going for it!

Alixana

Also very late to this party, and still waffling after reading all the comments (and thanks, everyone). My concern is that I currently have nearly-magic periods: super light, super short, zero cramps. I have been on and off hormonal BC, which has never adversely affected my periods, but I am terrified of buying myself a world of pain along with my IUD. So I mostly think I should just stay away? But it seems like such a convenient solution to all my BC worries!

* waffle waffle

MatildaGold

@Alixana I had that very same worry before getting mine (copper, but not the Paraguard - I'm not in the States). The first three months were pretty hellacious period-wise - heavy heavy heavy, cramps that caused tears unless I took hefty, regular doses of ibuprofen - but then it just leveled right out. They're still longer, 7-8 days on average as opposed to 5, and a little bit heavier, but totally manageable. I rarely, rarely take painkillers anymore. To me, that's worth it for years of thought-free BC!

MatildaGold

Way late to the party, but I love my copper IUD (copper T, not Paraguard - not in the US) so much that I must join the chorus. IUD!! <3 you!!

mangosara

question about IUD insurance coverage (perhaps somebody with more knowledge than I can provide insight on this front): at this point my insurance will pay 50% of the device cost and 80% of the insertion cost, but I'm a student and not really ready to pay that up-front when I can keep paying $10/month for the pill. I'm pretty sure that since I'm technically a dependent of my parents (and on their insurance) I won't qualify for the low income support... that being said I know that technically starting August 1st all birth control, as preventative care, will be ZERO COPAY! so... if I just chill out a few months will that be the case? like, I could get it now or in August and it probs won't make that much of a difference to me (as badly as I want one now) but I'd feel like a dummy wating that long for it and then having nothing change. there's a chance I'll be switching to new insurance around then depending on my employment situation, too.

Sparrow Morgan@facebook

@mangosara I do not actually know about August, but sometimes you can call your doctor and tell them the up-front cost is out of your range and see if maybe they will work out payments with you.

Sparrow Morgan@facebook

This was SO HELPFUL! I've been wanting an IUD but it is weirdly difficult to get straight answers out of OBGYNs about them. I am now ARMED WITH KNOWLEDGE.

(Also, oh man, thank you for telling me the ParaGuard leads to heavier periods, that totally made my mind up about which IUD I want, which is to say, Mirena all the way!!)

kayjay

I am so in love with my copper IUD that I'm probably going to marry it.

Emily C.

I love my Mirena so so much. It hurt horribly the first time I got one but I went to a different doctor last time and she anesthetized me before insurance. Couldn't even feel it happen.

Anne Smith@twitter

I just got a Paragard inserted not three hours ago.... after reading these comments I was terrified of the insertion process, but it wasn't bad at all! Two quick moments of intense pinching that made me gasp, and that was it. I practically skipped out of the clinic. I am nulliparous and am on the last day of my period. I also took 3 ibuprofin this morning, which probably helped. Now, it feels like terrible menstrual cramps, but mostly when I lay down/ don't do anything. Putting a tampon in made it feel better, oddly enough. I feel much better when I'm up and about than resting, so I'm going into work. Hurray!

By the way, if anyone is in the New Orleans area, my OBGYN rocks! Dr. Holman is her name. Also, thanks to my insurance, I paid $0... when the administrative lady at the clinic called my insurance, they said I wasn't covered at all, but when I called, they said I was... make sure to check with your insurance yourself!

badassfae

So... I joined just to comment.

I am Pro-IUD! I am 32 and have had 2 babies. The "Non-hormone One" was inserted 6 weeks after my second child- just about 5 years ago. I did notice some changes in cycle and discharge, but that all got settled out. Post having kids I had ridiculous menstrual cycles, so I can't say it made a big bit of difference. Now, they are very heavy, but short. I can use a Diva Cup, no problem. Generally speaking little to no spotting. I don't feel it, or have had any issues with intercourse or anything else.

emmeli

Just wanted to say that I got my Mirena exactly one week ago! I was totally freaked out and scared about it (I actually found a post it note the nurse accidentally left on the door that said "Room 201 - Nervous Nelly". But you guys, it barely hurt at all and I only had period-like cramps for a day, and then the next night I drank beer and also rode my bike like 18 miles! The spotting only lasted about 4 days and was tiny and I'm psyched!

255
255

SIDE EFFECTS: I'm thinking about Paraguard but is there a chance that Mirena could reduce my period side effects like bloating? But from what minion was saying I wouldn't want to risk the weight gain/body changes with Mirena, not to mention any libido risks. That's one of the big reasons I stopped BC 10 years ago.

255
255

@AmandathePanda Seriously abdominally you can feel it? I am a singer so my lower abs are basically my entire mechanism and I work out a lot using my transverse abs.... Am I going to be bleeding all the time with Paraguard?

255
255

@tallulah How is your sex drive on Paraguard? It mildly affects it or not at all? or just compared to pill BC?

255
255

Hey y'all! I DID IT!

So, I haven't seen many reports from women who were not on BC so I thought I'd post my experience on the insertion here. There are plenty of my comments here from when I was preparing to get my Paragard so you can see just how freaked out I was.

- So #1 and most importantly GO TO PLANNED PARENTHOOD! There's no doctor's office for whom your reproductive health is more of a priority, where people are nicer, and where making the process easiest for you is more of a priority. The desk folks, everyone was so nice; it was the best experience in a doctors office ever.
No one with more experience -- they do these at least 3x/day.
No one more honest - their integrity is very important to them.

- I am not on BC and my periods come w pain but not cramping. I went in at the end of my ovulation when I was actually spotting or bleeding a good deal. I was already tender. Though they offered me ibuprofen, I had taken 800mg 2 hours before my appt and took 800mg more after. I also take anti anxiety drugs so I took some before too.

- I called ahead to get a cervical block/the local anesthetic and I'm glad I did call! That way they had everything ready and I didn't have to worry about anything. I also qualified for a CA state program to cover all my reproductive health so I I did not have to pay for my IUD.

- I had a very thorough intake interview where they asked me about my history, whether I was going through a life change, and why I was getting the IUD. They answered all the questions I had collected from my research, though they advised me to only look at controlled studies for real evidence.

- Because I asked for the cervical block I got the NP who trains all the others for IUD insertion; she has been doing this for 18 years. She said not to worry about the Internet, just look at the clinical trials. But she answered my questions none the less. Here we're her answers:

If you're getting constant back pain it could be irritating a nerve depending on where it was placed.
Ibuprofen --an antiprosteglandin--works very well for the kind of muscle in your uterus/prostaglandins.
If you're feeling it during sex then you should come in to get it checked.
If you're feeling it at all you should come back in.

I asked her about the perforation risk and she said she's never had a perforation.

- Once I was in the stirrups I was tough until she asked if I wanted someone to hold my hand. Only then did I let myself freak out and release my fear. But they were wonderful and super kind of course. The worst pain was the anesthetic shots. She warned me that I might get a ringing in my ears or a funny feeling in my mouth. Really all I felt was pain that went down into my tailbone/rectum/ass. 3 shots and I was certainly loud about the pain.

- The rest was a breeze. I was warned that there would be a heavy cramp when they measured & when they put the IUD in. I had none of that. I had some mild cramping that started once she was done and I was lying there waiting, then it got a bit worse when I was dressed and sitting getting checked out, and a bit worse at dinner after my appointment but that's the worst it got. The rest was mild cramping and continued bleeding through the next day.

- The rest of the night I had some mild cramping soreness. I woke up in the night a couple times.

So here we go with my new sex toy.

BostonBoston

THREE months after getting Paragard, I had it removed! No hormones? I should have known it was too good to be true. I don't have any kids, but after trying every birth control pill known to mankind, I figured this was a last ditch effort. Insertion wasn't as horrible as I read about or anticipated, but the cramps that arrived TWO weeks before every period were AWFUL. My periods weren't any heavier than usual and lasted the usual 6 days with some spotting in between. No weight gain? Are they kidding? I looked like I was pregnant! Object in your uterus = body that thinks it's pregnant. I gained (retained water) 6lbs in three months. For a small frame that's a lot! Got it out yesterday and holy sweet relief. No more aching back, no more leg pain, no more cramping, no more pregnant lady abdomen. Side effects are gone. I would never recommend Paragard to anyone.

TARDIStime

BAHAHAHA at the Teva link!!!!!!!

george

Thankyou for what just might be the best article on this I have read. Love the no holds barred nature of the comments from you ladies as well. Dont hold back.
From - A researching Male.

LauraRebecca

Just had my mirena placed -- an option I wouldn't have thought of had it not been for this article. Thank you so much for writing this. Placement was just as easy as described, and I am really looking forward to lighter periods!

mist

is it true that these make sex painful and that the strings hurt the male and if so how likely is it for that to happen?

Toastface Killah

Just wanted to say that I had my Mirena put in a couple of days ago, and the decision was fully inspired by this article. I went to my OB/GYN and told her that I'd done my own research and wanted an IUD, and she said, "Then you've been doing the right research!" She has a Mirena too and loves it, so she was super gung-ho about giving me one.
Insertion took all of three minutes from "speculum" to "putting my pants back on", and only hurt for about 5 seconds. Teensy bit of cramping for the following couple of hours, but absolutely no other issues since.
I have named this magical little doohickey Cecile (after Cecile Richards), and I hope that she and I will have many happy, lightly-menstruating, baby-free years together.

andromeda.strain

paragard day 1: im not gonna lie.. i can only imagine the cervical dilation pain is similar to what men describe with a swift kick to the balls after a poorly thought-out remark in a dive bar to a toothless babe. Its a deep burning crampy pain that doesnt seem to match whats going on physically. the pain receptors on your cervix send shockwaves to neighboring organs in what can only be described as a a kind of potassium phone-tag where one area fires off that theres a foreign threat and the next cells pass on the info in an illogical manner.

Rewind.. My mom just died of endometrial cancer.. she also had polycysticyourlifeisgonnasuck disorder where she got funyuns on her ovaries and had to get them removed.. too late as it spread to lymph nodes and lungs where she had to watch psa commercials on tv while she herself was battling with a non-elective cancer of the lungs as advertisers were trying to scare kids from smoking cigz. no one said life was fair. so yea, having a little more control of the voodoo going on downstairs is appealing to me.. even if it means i have to endure more bullshit.

after much research i came across this site where the bennies and cons of paragard vs mirena are discussed by babes who are not sugar coating the issue. i too have had bad experiences with chocolate chip cookies (not derived from cocoa beans) and was looking for a nonhormonal solution to not getting preggers after having gone through brain-cloud on yaz, orthoevra, the patch, the ring.. you name it. My partners and now husband have thankfully been amazing at pull-out and saved their best performances for the Menses Day Parade (you gals call it shark week) but being over the age of 30.. hormonal methods carry other risks now and im hornier than the average bear.

So heres the 411 bitches.. go right after your period because your cervix is more dilated than normal... make sure to take 3 to 4 advils before you go (i didnt) otherwise youll regret it. have hot pads ready when u get home and dont schedule any bareback romps for at least till the bleeding stops (even if youre kinky). i was nauseous, dizzy,and lightheaded after the procedure.. you might be smarter if you have a pal drive you home. have pantyliners ready at home because youll bleed. someone earlier mentioned a bottle of wine.. omg that was the best advice. have a bottle of wine on hand. that made EVERYTHING better and helped me sleep.

So before signing up for your alien implant.. try to have these comfort items handy. it will make your road to recovery much swifter. signing off now.. happy womb invaders to you all! ;)

martinipie

@andromeda.strain Lady, I don't know who you are, but you have both a) amazed me with your commentary and b) 100% convinced me to get a ParaGard.

yonge79

All the ladies in my friend-group have mirena, but none of their people had much more than the best week of misery. I, in the other hand, had the kind of doubled-over, dizzy, shouldn't be driving or perhaps walking or sitting at my desk sort of pain. This is just like I was giving birth on as well as off bulletproof athlete a couple months.

Francesco Colasuonno@facebook

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Renu2

I just wanted to put my nightmarish experience with hormonal IUD out there because I feel like I haven't heard anyone talking about these issues:

I had mine put in while I was in college. I had lots of friends with the IUD who only said positive things about it. After getting it in my IUD just kept hurting. My body was always trying to push it out of my body. I also developed a systemic fungal infection (not a vaginal yeast infection but actually i was getting ring worm on my skin. The doctor insisted this was unrelated to the IUD but now in retrospect I strongly believe it was related) The IUD also always felt like it was always poking me. I went back to the Women's health clinic where I had had it inserted. They trimmed the wire but they told me everything was fine. That this was normal, that it would heal in a few months. I kept the IUD in, although it was a constant dull pain, for 6 months. During this time sex was painful, i was irritable, my periods had completely stopped, and towards the end my moods started going berserk. I went into a state of super adrenal overdrive, like my body had just been in fight or flight for too long and I became permanently wired. I went to get the IUD out, this time at planned parenthood. AND THEY STILL ENCOURAGED ME NOT TO GET IT REMOVED. They told me that those symptoms were probably not related to the IUD. This makes me so angry in retrospect because now, almost 2 years after having the IUD removed I have a plethora of medical and health problems that are directly related to the IUD. Why at every attempt to have it removed was I told by doctors to wait it out???? it makes me so angry.

After having the IUD removed my body freaked out from the withdrawal of the hormones. As it turned out I was genetically predisposed to have autoimmune hypothyroidism and it was the IUD (and my body freaking out at having this foreign object full of foreign hormones in my body) that caused my immune system to go into overdrive setting off my genetic marker for hypothyroidism. (Note: for many women hashimotos hypothyroidism is gets set of by pregnancy or menopause so it should come as no surprise to doctors that this would also be a risk for girls getting an IUD which simulates pregnancy). Now in addition to living the rest of my life with an autoimmune disease which may not have been onset until I was much older I also have ongoing sexual health problems that are directly related to my body clenching trying to push out the IUD. I still have a dull pain in my uterus area where the IUD once was, I occasionally still have muscle spasms there despite acupuncture and other work to undo this problem. My hormones never adjusted fully back to normal, my sex drive is nowhere close to what it used to be. and deep penetration is painful, I have horrible PMS which I had never experienced before in my life prior to the IUD.

I wish someone had warned me about these possibilities before I had gotten the IUD. I chose to get it because I thought it had fewer side effects than other hormonal options. This is a medical horror in my life. I understand that it works for many women but I just wanted to warn others that for others it can be a life-changing health-altering experience.

User beware

samjohn4810

You ask yourself, “Is the bad stuff I’ve heard true? Could we work together — even in the long term?” If we’re still talking about IUDs, and I’m not sure we are, there are good answers to your questions. Let’s "I" and "U" "D"-scuss St Louis Snow Removal

samjohn4810

You ask yourself, “Is the bad stuff I’ve heard true? Could we work together — even in the long term?” If we’re still talking about IUDs, and I’m not sure we are, there are good answers to your questions. Let’s "I" and "U" "D"-scuss St Louis Snow Removal

samjohn4810

You ask yourself, “Is the bad stuff I’ve heard true? Could we work together — even in the long term?” If we’re still talking about IUDs, and I’m not sure we are, there are good answers to your questions. Let’s "I" and "U" "D"-scuss St Louis Snow Removal

samjohn4810

The IUD is a T-shaped plastic or copper device that hangs out in your uterus as the most effective sperm scarecrow money can buy. It doesn’t protect against STIs. The two kinds available in the US are the Mirena and the ParaGard, and they both fit in my mouth. sponsors forum

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From your explanation above, I think I would choose MIRENA rather than ParaGard. However, I still concern with its side effect that can cause yeast infection / whitish. It's so nasty.

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I wish someone had warned me about these possibilities before I had gotten the IUD. I chose to get it because I thought it had fewer side effects than other hormonal options. This is a medical horror in my life. I understand that it works for many women but I just wanted to warn others that for others it can be a life-changing health-altering experience. Portland Hypnosis

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I was not planning on more children at all). It all worked out for us in the end, but the realities of getting pregnant with an IUD in are more dangerous than getting pregnant while on the pill. If I had to, I'd probably still get the IUD, but would like to have been more informed about the "what ifs" of conceiving with it in! best dress shoes for men

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WastedPaper YES! this is often how people get pregnant "on the IUD:" there's been an expulsion, the person doesn't notice because expulsion can often be "silent," and there you go. hence the string checks.
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I forget it's even there. And after 15 years of horrible, curled-up-on-the-bathroom-floor periods, I now get an extremely low-key period for like one day max? Like I don't really even need to use tampons anymore.
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bilo rani

This is now the third Blue Cross plan I've been on in the last five years and probably the best. (BCBS of ME, AL and now MA) I live in California and finding a provider for IUD insertion wasn't a big deal. My ob/gyn nurse practioner was happy to do it and had both available on appointment day if I changed my mind.
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@likethestore While i realize the failure rate is low, I am one of that few percent that got pregnant on the copper IUD, i had it put in in october 2010, last april i got pregnant and I now have an 8week old baby boy. Honestly, I have also heard from a few other people that have gotten pregnant on the IUD. Implanon i hear is even better and even lower chances of pregnancy. mobile web development

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