Last week, I got a Mirena IUD. I’ve been on the NuvaRing for about two and a half years, but I’ve wanted an IUD for at least that long. I discussed switching with my boyfriend, who was enthusiastic, and I’ve been passively considering how to go about this for a couple of months now.
I decided to actually get it done about three weeks ago, when I was alerted by my campus healthcare provider to a state-wide anti-pregnancy program that provides free birth control and anti-pregnancy-related appointments. My insurance is already pretty good–I’m insured as a graduate student and teaching assistant–but an IUD was prohibitively expensive on that plan. On that insurance, I have to pay for things up front and get reimbursed later, so I’d need to have a spare $600+ around to get an IUD inserted. This program, available in Oregon but with similar programs in other states, required me to fill out some paperwork, prove my citizenship (but not state residency, interestingly), and then schedule a consultation. I had to notify the receptionist that I was interested in an IUD because that consultation appointment is 30 minutes instead of 15.
(I had actually heard of this program, Oregon C-Care, before, but didn’t realize how useful it would be/bother to enroll until a friend used it to get a free IUD recently. I had also expected it to be more of a hassle than it was– I only had to fill out two forms, show my passport, and make a consultation appointment. It took less than a half hour total to do. I really hate paperwork, so this was vital.)
The day of my consultation, I chatted with my doctor about why I was interested in an IUD and the differences between Mirena and ParaGard. I was initially interested in the ParaGard, because I’m minorly concerned about hormones, but my doctor pointed out that Mirena uses about 1/10th of the hormones of most major BC pills and they’re much more localized; while there will be measurable amounts of additional progestin in a user’s blood stream, it will be a lower level than on oral contraceptives, Depo-Provera, or even the NuvaRing (all of which I’ve been on). In addition, Mirena is more likely to completely eliminate your period over time, and I’m pretty unenthused about my monthly bleeding. Until last week, I stacked my NuvaRing insertion so that I didn’t have a week off to menstruate; when I told my doctor that, she suggested the Mirena met more of my needs than ParaGard. Even so, she was open to discussing both options at length and dispelling the myths often associated with IUDs in general, some of which had been perpetuated by my old gynecologist (like that the string acts as a wick to increase your risk of uterine infection). She also was honest about the risks that come with insertion, like puncture, infection, and pain.
We scheduled my insertion for two days later, the Friday morning of finals week, when I also had a 15-18 page term paper due. I told her and the medical aide about my paper due later, and they decided to administer an additional painkiller after the insertion so I’d be better able to finish my work. Between my Wednesday consultation and my Friday appointment, I started taking Aleve with meals, ending with 2-3 pills Friday morning. I had a typed sheet of instructions for continuing to take Aleve after the insertion. I also read/heard somewhere that exercise can help one’s pain tolerance, so the morning of my appointment I went on a short jog to get my blood flowing. (Later the medical aide told me this isn’t just a rumor–exercise can help with pain management. She recommended walks instead of runs for a few days post-insertion, though.)
The appointment was very straightforward and low stress. I can’t promise that the ease of my appointment will be similar to everyone’s experience, but I think it will reassure some people who are nervous.
My doctor showed me all the tools she’d use before I disrobed. The medical aide, who also leads meditation classes at the school clinic, offered me a homeopathic pill to start treating initial stress and pain. I wasn’t particularly anxious, though, so I didn’t take that one. When the procedure itself started, the aide started leading me in deep breathing: a slow, long inhale to fill and expand the belly first, followed by a pause before a similarly long and slow exhale. Then a long pause at the bottom of the breath and repeat. As I was doing this, the doctor numbed my cervix with novocaine; at this point I felt tired and mellow, and I briefly felt numbing in my tongue and heard their voices as tinny and echo-y–I think this was due to the medication’s initial effects combined with the deep breathing, but both of those responses disappeared quickly. I continued the deep breathing, listening to the aide talk me through calming imagery and to quiet, yoga-like music in the background, as the doctor measured my uterus. This can be painful, but I barely noticed it was happening. The doctor determined that I was doing fine focusing on the breathing and stopped announcing each step of the procedure, so I was alerted to the actual insertion by somewhat noticeable cramp-like pain. This was extremely brief and the breathing helped me get through it quickly.
Afterwards I did a few more minutes of the breathing while the doctor cleaned up, and I took a homeopathic pill and rested. Evidently it’s not uncommon for women to be faint at this point, so they kept me lying down. After a few minutes I felt very mild lower back pain (where I often experience menstrual cramps) and the medical aide had me do a stretch to work that out, which helped. The doctor brought me juice and had me rest a few more minutes, and then the aide administered my pain shot (which was the most painful part, I think–it’s an enormous shot in your butt muscle).
To reduce spotting this first month, my doctor recommended I leave my NuvaRing (which I’d just inserted the weekend prior, on schedule) in until I’d normally take it out. I had minor spotting that first weekend, and then nothing out of the usual. I took a fair number of Aleve tablets the first weekend (and finished my term paper, thank God), but was able to go on a long jog on Sunday. (This did cause some cramping afterwards, but it was minor.) For the first three days, nothing except the NuvaRing is “allowed” in the vagina, since the cervix can be a little traumatized in the insertion process. In the week since, I’ve felt extremely minor, passing cramping only a couple of times. In each instance it’s been only a minute or two, and I’m not entirely convinced they’re not in my head. I worry a little bit about twisting my midsection in such a way that the ends of the T will push through and rip up my insides, but I’m pretty sure that’s impossible. For now my uterus and my brain are just getting used to having a new thing in there.
I’ve had friends use the same doctor and medical center report more pain and trauma than I experienced, but I’ve also had friends report very similar experiences to mine. Worst case scenario, barring puncture or infection of course, seems to be two 10-15 second intervals of pain during insertion and potentially severe cramps for up to a week afterwards. I think this is extremely worth it for five years of birth control (and my doctor said it looks like the FDA might be extending that time limit to seven years soon), but that’s easy for me to say since mine barely hurt.
I’m happy to answer questions about my recent experience, and tons of other readers and writers here at Persephone have experience with IUDs and other BC methods, so it should be easy to get all the information you’re hoping for if you’re considering getting an IUD, which I obviously highly recommend! There’s also tons of general information about IUDs in this Persephone article by Coco.