Two years ago, I got an IUD and it was the best thing I ever did. Ever since, I’ve become one of those proselytizing women who want to talk to you about Diva Cups in line at Whole Foods, except in favor of a small t-shaped baby-prevention device. Have you accepted IUD into your uterus as your personal peace of mind?
Part I: Insertion
(Okay, that makes it sound scary, but that’s what happens.)
Conveniently enough, my past self documented this all for Tumblr two years ago, so I will simply re-post my day of recollections from when they were fresh. Heads up, this naturally contains descriptions of the goings on in my cervix, so if that’s not your thing then for one getting an IUD probably isn’t for you, and for another you should probably close this tab.
I didn’t get any crap from the NP who made me the appointment or the OB/GYN who inserted it, but I know that a lot of doctors are kind of pissy about giving IUDs to younger, unmarried women—just so you’re aware.
The first thing they had me do was a urine pregnancy test, and if I hadn’t done a Pap smear and the full STI panel the week before at my physical I think I probably would have had to do those, too. When everything came back negative, we went ahead with it. She asked me some questions about what medications I was allergic to, but nothing about my sexual history other than if I’d ever been pregnant.
The IUD itself is a little T-shaped device that comes with an insertion tube. Basically, it sucks the T back into the tube, and then pushes it out on the other side of your cervix. So kind of like a tampon? I got the Mirena, which is hormone-releasing and marketed for five years, but good for seven. Paragard is marketed for ten years and tested for twelve (Ed. note: I have this one and love it).
So for the fun part. Overall, I’d have to rate this the least pleasant experience I’ve ever had without pants on, but the pain was not much at all in the grand scheme of things, and I had a particularly difficult insertion. It was nothing, for instance, in comparison to breaking my ankle, and I’d go ahead and rate it as better than a bad UTI if only because the whole thing was shorter-lived.
The first part of the insertion is for the practitioner to determine the location of your uterus. This involves sticking a couple of lubed up fingers up there and patting your abdomen a bit. If you’ve ever had a pelvic exam, this is the same thing you’ve experienced before. The lube is cold, and obviously having a strange lady’s latex covered hands up your vagina is awkward, but this part is not bad. Next, she inserted the speculum, which again, awkward and uncomfortable, but no pain.
Then, they wash your cervix. At this point she was asking me questions about my life and I was waxing poetical on obscure regulatory updates in certain aspects of the U.S. health care system related to my job, so I didn’t really feel anything other than the speculum. I have to say that one of the weirdest parts of the procedure is the noises of the different things rattling around in the speculum, which was one of those disposable hollow plastic ones that they can stick light attachments in, and send tubes through, etc. You’re like, “Hello? What is that rattling noise coming from my vagina? This is bizarre.”
The next step is to numb the cervix with lidocaine, which I also didn’t really feel except for maybe a little bit of pinch. But it really was just a pinch, and not like sometimes when they say, “You’ll feel a pinch!” and what they mean is, “I’m about to jam this into your cervix and that shit’s gonna hurt.”
Next, they poke around your cervix trying to find the best way in. She was not particularly forthcoming about narrating this part because this is where things started to go a little wrong for me. The sensation of your cervix stretching is not one that I can really describe if you’ve never experienced it before. You know how sometimes you try a new machine at the gym and you’re like, “Holy shit, I did not know I had those muscles and I did not know I could hurt them”? That is kind of what this was like. Apparently my cervix is “tricky,” which I believe was the diplomatic term used. Every time she found a way through with whatever mysterious implements she was using to pry it open, she’d come back with the IUD tube and the opening would have shifted. This is kind of hilarious to me an hour later, because of fucking course my cervix is a shifty bitch, but it was nothing resembling hilarious at the time.
I am going to go ahead and recommend that you talk at length with your physician before undergoing this procedure if you have any rape trauma to speak of. For me, while it was certainly invasive, it was not a big deal, but I do remember thinking at this point, “How much random shit is even in my vagina right now? This is not cool at all,” and I feel like this would be extremely uncomfortable or even very triggering for someone with any trauma associated with penetration.
My provider was very good at checking in with me every couple of minutes to see if I was still doing okay, especially as the procedure ended up taking a lot longer than anticipated. Though at one point she did have to leave the room to get another two Mirena kits because apparently my cervix eats IUDs for breakfast, and she left me there just hanging out with the speculum, etc. and that was not fun. I guess I wouldn’t have preferred she take it all out and start over again, but that was not great. And at another point she said, “Oh!” and I was like, “…Yes?” and she said, “Well, you’re bleeding more than I would like, but it’s fine!” which is kind of like when your hairdresser says, “Oops!” only with cervical bleeding.
Anyway, there was quite a bit of poking and prodding and rattling of miscellany in my vagina because my cervix has Heimdall aspirations. I made a whole lot of faces at the ceiling. The pain was pretty comparable to really bad menstrual cramps, but with prolonged intensity coupled with having a bunch of random shit in your vagina. This went on for a while, and my provider asked several times if I wanted to stop, but I said I was fine. Right about the point at which I started to feel like it just wasn’t going to happen, she got it in.
After she took out all the tubes and whatnot and finally the speculum she had me relax and breathe for a couple of minutes while lying down, followed by a couple of minutes of sitting up with my knees up and my head between them, even though I didn’t really feel dizzy.
After she had determined that I was determined to leave, and to drive myself home, she gave me a pad and sent me on my way. She said unless I experience any problems she doesn’t think I need a follow up appointment. The risk of infection is highest for the first three weeks, so it’s recommended to not have sex or use tampons for the first couple. She also told me that they’ve changed the pap smear recommendation to once every three years, so the more you know and all that.
Right now, I am lying in my bed eating ice cream and I feel okay, but not great. Definitely crampy. I’ll probably take some more ibuprofen and a nap in a little bit.
For another insertion experience, you can also consult Sequined’s earlier post.
Part II: The Immediate Aftermath
Not gonna lie, when I posted that two years ago I assumed that the minor cramping I felt would be the worst of it, but I was mistaken. I experienced pretty intense cramps for the first three days or so. Enough that I wandered around clutching a makeshift heat pad made of a plastic bag of microwaved dried rice (which, if you’ve never done it, I highly suggest in a pinch) and whining a lot. However, I assume that this was far less discomfort than one experiences during an unplanned pregnancy, so in retrospect totally worth it. My first period after insertion also lasted for a month straight, which was unpleasant. Between the literature my clinician provided and asking around for other people who had an IUD, these are pretty common experiences. Obviously, in terms of unexpected bleeding, listen to your health care provider over the soothing words of some random lady on the Internet, though.
Part III: The Spectacular Now
First and foremost, I have not had an unwanted pregnancy! The IUD is doing its job! As expected. But as a person for whom taking a daily birth control pill was a struggle, and who eventually found condoms in the context of a decade long stable relationship to be a nuisance, my IUD is probably the number one sanity saving piece of technology in my life save maybe my smart phone. My smart phone, on the other hand, has dropped infinitely more calls than my IUD lets errant fertilized eggs through, so it’s not much of a contest. After the first month, my periods faded away to nothing and except for some minor occasional spotting, I haven’t had one in probably a year and a half or so. The last time I went to the doctor—in full disclosure because I am a failure at California I went to the beach and got sand in my contact and had to get antibiotic eye wash—the intake nurse asked me about my periods. When I said I had an IUD and didn’t get them anymore she whispered, “Me, too!” and high-fived me. When I moved out to the West Coast, some combination of the higher heat and humidity or the increase of smoothies in my diet made my nails and hair grow mysteriously doubletime. I made the mistake of mentioning this on the Internet late at night, and a stranger immediately queried whether I had any other reason to believe I was pregnant. After some frantic googling of “pregnant with IUD” and reading forums of horror stories, I drove to the Rite Aid in my pajamas and wet hair and bought a pregnancy test from a bemused clerk. Nope; not pregnant. So while it’s not a foolproof system—as Puritanical sex education throughout this great country of ours will tell you, the only 100% guarantee against pregnancy is abstinence—I’ve bought exactly one pregnancy test in the two years I’ve had an IUD, compared to at least one a year in the mumblemumblenumber of sexually active years prior to that.
Rating: One happy, empty uterus!
Use Again? As I announced to my fiance while stumbling down the street after a couple of birthday cocktails last week, “In a few years, we can pop a kid out of here and pop a new IUD RIGHT BACK IN.” So, yes.