Have IUD, Will Travel

The IUD has suffered years of a bad reputation. Once lauded as the device that punctured a thousand wombs and rendered hoards of women sterile forever, its gradual re-acceptance has been gaining over the years.I blame big pharma and the manufactured fear mongering of a cheap and effective birth control that you don’t have to purchase every month. I also blame a lack of education, fears of systemic sterilization in multiple communities, and a few other obstacles that have made the IUD less popular then it could be. Only 2% of American women are using the IUD, yet worldwide, its one of the most popular forms of reversible birth control. 33% of Russian birth control users are IUD users ““ 40% in Kazakhstan45% in China, and overall rates of 27 % in the countries that represent the European Union. With lingering fears from the 1974 Dalkon Shield case decreasing and the FDA regulating more birth control products, it might be time to look at the option of an IUD working for you.

First off, what exactly is the IUD? The Intrauterine Device is a small “T”-shaped device made of a soft, flexible plastic, inserted into your uterus for long term pregnancy protection. There are two types of IUDs.

The Paraguard IUD This IUD is a non-hormonal birth control and contains copper. The copper in the IUD works to negatively affect the mobility of sperm and essentially acts like the Death Star, blasting sperm back into the twinkle in the eye from which they came forth. This IUD is effective for 12 years.

The Paraguard IUD. Courtesy of Planned Parenthood.

The Mirena IUD This IUD is hormonal and releases small and balanced amounts of progestin, working similarly to most hormonal birth control pills, keeping you from releasing eggs during ovulation and thickening your cervical mucus, creating an impenetrable barrier, a fortress of solitude from your bodily fluids. This IUD is effective for 5 years.

The Mirena IUD. Courtesy of Planned Parenthood.

Secondly, how much is this puppy gonna cost? It all depends. IUDs range in price, like most birth controls, but on average can cost around $500. Before anyone looks at me like I’m Captain Moneybags aboard the S.S. Dollar Boat, let’s make it clear that most often you do not have to pay that total. If you are lucky enough to have a decent health insurance plan, it’s possible to get all or most of the cost covered. No health insurance? Planned Parenthood works on a sliding scale payment plan, an option that provided me with the ability to purchase an IUD for only $50. If you do decide to go the route of your local reproductive health clinic, you most likely will have a free cost analysis meeting and will speak with one of the clinics representatives on the best way to ensure that you are able to get an IUD at a price that is best for your financial situation. A good thing to remember to is that it’s a one-time payment, upfront for five to twelve years of protection, but even then most clinics work with monthly payment plans. Mathematically speaking, you end up paying less up front than over a span of so many years for other forms of birth control.

Next, there’s the insertion. I’m not going to lie – this was the worst part about the entire experience. For those who have experienced surgical abortion, there can be some potential semi-triggering similarities to the process. It’s recommended that if you have an IUD inserted, its best to do it mid-cycle, when your cervix is the most open, but an IUD can be inserted at any time. It also can be inserted 48 hours after birth, immediately after an aspiration abortion, and four weeks after a surgical abortion. The process is unpleasant but quick. Your provider will open up the vaginal canal with a speculum, administer a topical anesthetic, and clamp your cervix with a tenaculum. They will measure the length of your uterus with a uterine sound – this is about ten seconds of discomfort and slight pain as they essentially send a small thin ruler up your uterus. With the same uterine sound, they will administer the IUD through, placing it in the top of the uterus, causing another few seconds of discomfort and pain. When I had mine inserted, I experienced the discomfort and pain but also dizziness and faintness. After the IUD is in place, your provider will cut the IUD strings that will hang a few centimeters out of your cervix – these will be the way that you continually check to make sure everything is okay from now on. After the procedure, my clinician allowed me to have a few moments to myself and gave me some pads for the slight bleeding that will occur as well as juice and crackers. You will have a follow up scheduled for four to six weeks afterwards to check on the status of your IUD.

IUD Positioning and Placement. Image Courtesy of the McGraw-Hill Companies.

The benefits – In the long term, it has provided me with an inexpensive and long lasting form of birth control. I chose a non-hormonal Paraguard copper IUD, so I don’t have the typical side effects of most birth controls available. However, if you feel more comfortable using a hormonal birth control, the Mirena IUD is able to reduce menstrual cramping and flow, allowing for more manageable periods. For my ladies with fibroids, both can be an option and help reduce certain cases of fibroids. Suffer from endometriosis? There is a 40% risk decrease in endometrial cancer with the use of the Paraguard, and the Mirena has become an effective treatment to the most popularly used leuprolide acetate injections. Considering pregnancy? The ability to become pregnant becomes possible as soon as you have the IUD removed. Avoiding pregnancy? The IUD has proven 99.8 % effective and less than 1 out of 100 women a year will become pregnant on the IUD. The Paraguard IUD can also be used as an emergency contraceptive if inserted 120 hours after unprotected sex. Safe, effective, and cost saving.

So what are the downfalls of the IUD? First off and most importantly, it’s a non-barrier contraceptive, which means no protection from STI or HIV transmission. As Momma always said, “Wrap it up“ – something that is extremely crucial with having an IUD if there’s a possibility of new or multiple partners. As miraculous as it is, it still does not offer the simple but advanced protection of a barrier method. If you do have an STI or get an STI while on an IUD, get it treated immediately. More than likely your IUD will be removed so bacteria won’t travel into your uterus, thus avoiding PID (Pelvic Inflammatory Disease). Other than that, there are a number of uncomfortable syndromes: moderate pain when the IUD is first inserted, cramping and backache, plus spotting. During the first few months of having an IUD, cramps are often the worst – those who have an IUD in place may experience irregular or heavy bleeding. There are also very serious but rare side effects, like developing an ectopic pregnancy, which is when a fertilized egg grows outside the uterus, usually in a fallopian tube. Other serious risks include the IUD slipping out of place, the IUD imbedding or pushing through the wall of the uterus, and serious infection. These again are all are rare, but like any major risks, something to consider.

My own IUD has been something of a life-changer. Three years into having it, I don’t have the constant fear of developing the blood clots in my legs that I was once prone to, nor the depression caused by the excess hormones in my body, the all-night vomiting, or the scare of a broken or slipped condom. I’m able to enjoy sex more now without the extra anxieties. It’s a real privilege to be able to feel that way. To find out more information on whether or not an IUD might be a good choice for you, visit your local clinic or doctor, or check out more information on IUDs at Planned Parenthood’s breakdown of contraceptives. Until next time, stay safe and stay protected.

For more information on IUDs and to see if they might work for you, check out Planned Parenthood and Hesperian.

Editor’s note: This is Persephone Magazine’s 2000th post.  Gitter IUDs for all!

18 replies on “Have IUD, Will Travel”

I had my Mirena put in about 8 weeks after giving birth. I didn’t even feel it. I was so terrified going in, because the last time anyone had been down in that area, it was … well, I won’t go into the gory details. You know what birth is like.

Anyway, the doctor fussed around down there for a few minutes then popped and said, “All right, you’re good to go!” I couldn’t believe it.

I’m about 10 months postpartum, and I don’t think I’ve had period. (I’m nursing, but not so much that it should be suppressing periods at this point.) Some spotting and cramping, but nothing that I would actually call a period. All I paid was a $20 copay, because I’d already used up the deductible for that year having a baby.

Love it!

I’m getting my second Mirena on Monday, after 5 years with the last one. For me, it’s been a godsend, and while I’m not looking forward to the “exchange” procedure tomorrow, the minor discomfort of that insertion day has been totally worth it.

I would like to mention that many providers will prescribe a dose of Misoprostol to be taken the night before your appointment, so think about asking for this. Yep, it’s the same drug that is used for medical abortions. It softens up the cervix to allow easier passage of the instruments and the device. Esp good idea for nulliparous women (like me)!

It’s also important to know that there are not just two different models of IUD. This is crucial. Here in the UK, and I suspect also elsewhere if you ask your healthcare provider, we have a number of different brands and models of IUD. A good doctor will be able to fit you with the most appropriate model for your body.

I had initially wanted a 12 year copper IUD, but my NHS doctor measured my uterus and told me that while she could fit one, it would be more uncomfortable and present a higher risk of rejection. She recommended a much smaller copper IUD which only lasts for five years but would have fewer side effects.

You will hear an echo-chamber of negative experiences about any medical procedure online, but as always the best outcomes occur when you are your doctor are working together, so don’t be afraid to ask for more information. And don’t be freaked out by insertion! I have a tiny uterus and have never had kids and mine was absolutely manageable.

I stopped hormonal birth control last May and ordered a Paraguard. Unfortunately my periods have been super wonky and I’ve never been able to go in on the first day (when my doctor suggested I have it inserted). of insertion. I have some serious painkillers to take, so I’ll have someone drive me. But yeah, panicked. I just don’t want to put hormones in my body anymore :(
Anybody have experience with DivaCups and IUDs?

Don’t be panicked! I know people have different levels of pain tolerance, but I feel like “the horror!” of IUD insertion gets a bit exaggerated. The process is over in minutes; the cramping afterward is on par with regular menstrual cramps; and I’d say at the “worst” part of the insertion, I’d still only put it at about a 5 or 6 on the pain scale. Just my perception, obviously, but I feel like you hear sooo many stories of women going on about how it was the “worst pain evar!!” when I think there are probably an equal number who didn’t think much of it and thus never felt the need to share their stories in online message boards. You know? It’s less compelling to run home to your computer and be like, “Omigod you guys! I just got my IUD, and it was….. mildly to moderately uncomfortable for few moments!!!” :-) Just take your painkillers and don’t be scared!

I used a menstrual cup with my IUD. It’s not a problem. The first time after the IUD, I felt like I had to be extra careful about breaking the seal before trying to remove the cup, but I got over it pretty quickly.

Don’t worry! You’ll be fine! Just lie back and think of England!

Thanks for the feedback! I consider myself to have a very high pain tolerance, but last year I got a colposcopy after an abnormal pap and almost fainted, although I can’t be sure if it was the pain or just the knowledge that she was cutting apart my cervix. I’ve also had my nipples pierced and donated my eggs (twice- part of the reason I don’t want hormones in my body anymore) and was fine with the pain after that (I think it’s similar to an abortion, since the eggs were vacuum aspirated out – not sure though) so I think I’ll be able to handle it. Just seeing comments here and on Jez when they did a similar post scare me to death – one woman said it was worse than child birth!

Don’t worry! IUD insertion is NOT worse than a colposcopy…you will be fine. For me (no pregnancies) IUD insertion hurt like crazy – I will not lie – but it was very, very quick. And the aftermath was just a little cramping for a few hours. It’s the best thing I’ve ever done, in terms of birth control, and I just wish I’d done it ten years earlier!

this is a very informative post!
I want to add something about ectopic pregnancy, as my sister had one with IUD (she’s super fertile, apparently). this is a life threatening situation and must be dealt with ASAP. there are two kinds, the fertilized egg can grow either in the fallopian tube or in the cervix. both are dangerous but the last is much more complicated (and of course that what my sister had… poor thing). you can’t abort surgical if it’s in the cervix and it is treated with chymo (small dosage but non the less). in most cases (not my sister fortunately) it end up with hysterectomy. now I’m not telling this to scare you of and IUD. my sister had a new one inserted and she’s good, and as this post clearly demonstrate it got a lot of benefits. my point is that if you get pregnant on IUD, or even if you’r just worry you might be, you should run to the gyno to have it checked.

I wanted to chime in on this one. I had the copper Paraguard inserted a few years ago because I wanted a non-hormonal BC. I left it in for a year, and during that year my periods were so heavy and so long that I became anemic. The cramps and the PMS were horrible as well (they told me this was normal, and that it would get better with time). Like, seriously, I would have panic attacks and would feel like I had to leave the house or I was going to suffocate to death, and I had never had PMS like that before the IUD. However, the deciding factor that made me go in and have it removed was that it physically poked me, not all the time, but often. I was trying so hard to get my menstrual craziness under control, but I just couldn’t take the poking and the pain that would come out of no where.

When I went in to have it removed I felt like a failure, like I had wasted the IUD. The nurse said that it happens sometimes when the IUDs are inserted into women who have not had children yet, and the uterus is still tiny. I still felt bad, like it was my fault.

Although I had some problems with the Paraguard, I had that full year of pregnancy protection so I know it is effective. I plan on having another one inserted after I have a child (if I have one). Hopefully, the poking problem will not be an issue then.

I had a Mirena for a few years, just got it removed recently. The insertion process was pretty bad, but only lasted for a brief time (and all I had was a couple of Advil 1/2 hour beforehand for pain). My periods ended up stopping completely, and I’m pretty sure I stopped ovulating. I only got cramps when I was in high-stress situations. The only bad side-effect it had for me, which was the main reason I ended up getting it removed, was that it killed my libido. Totally killed it; I was virtually anorgasmic for a couple of years. Since getting it removed (in November) I’m still not quite up to my previous (very high) libido. I may well get another IUD, but it’ll be a copper one next time. I’d rather have to deal with possible longer periods than lose my sex drive again. That being said, I know it’s meant to be an uncommon side-effect, and certainly not one I experienced when I took various oral contraceptives, so I guess I was just unfortunate enough to react poorly to that particular form/dosage of progesterone. (Oh, and the removal didn’t hurt at all for me, I barely noticed it)

I am evangelical about how much I love my Mirena. I’ve convinced 4 friends to get one (they all heart them) and have 3 more friends contemplating getting one. It has been a dream for me and after about a year of having it, my periods have stopped completely. I still get a little PMSy for about one day a month, but no bleeding. I’ll never be able to go back to the pill, and I say that as someone whose body was very pill-friendly.

Tip for insertion: Make sure they give you a Novocaine shot in the cervix. I was given one and from comparing stories with other women, it does a good job of significantly decreasing your discomfort, especially when they’re measuring your uterus with the sound. I went to Planned Parenthood for my insertion, since then I got a doctor who had done hundreds of insertions. The doctor who I asked about getting an IUD initially was wonderfully supportive, which was great since I’ve heard of other nulliparous women being discouraged by doctors who don’t know the stats about the new IUDs and nulliparous women.

I love mine, too, and had a great doc who was very supportive and encouraging. I also love the fact that I spot for about six hours every month, and that’s the extent of my period.

But to be perfectly honest, I had my cervix numbed before the insertion, and it was still mindbendingly painful. When the doc and nurse left to give me a couple of minutes to collect myself after the insertion, I nearly threw up in the wastebasket. I’m pretty sure that I’ll get another Mirena when this one expires in another couple of years, but the prospect of facing another insertion makes me cringe.

I just had my Mirena IUD removed this week, after having it for about a year. My dermatologist and I finally pinned it as the likely cause of the *insane* acne that had been attacking my face for the last year, which is such a shame because I’d been really excited to have an IUD for all the reasons above. I had initially been interested in the Paraguard, but the other issue I had was really long periods (7-8 solid days of bleeding) and terrible cramps, so the doctor suggested the Mirena. And the Mirena did help those things! Cramps were gone! After 7 months or so, I barely had a period at all! But Mirena and my face HATED each other, to the point where I just felt like a giant zit-monster undeserving of sex or human love! So, sigh.

As far as insertion goes, I didn’t think it was bad at all. I scheduled the appointment to fall while I was having my period and took about 5 ibuprofen an hour before. It felt sort of like a strong, sharp– but brief– menstrual cramp, and there was this strange sensation of something… giving you a cramp from the inside; but it was all nothing to write home about.

I do think IUDs in general are great, and the Mirena is great for a lot of women– I just happen to be like the Princess and the Pea when it comes to hormonal birth control! I’ll probably try the Paraguard at some point and see if that doesn’t make my long, crampy periods even longer/crampier.

Great post!
I have the Mirena IUD and I love it, your post pretty much explains why IUDs are a great option that is underused. Mine cost $50 with the insurance I had at the time, the same insurance charged $60 for a three month supply of birth control pills.
Also, getting it put in did hurt really badand made me feel lightheaded, but like you said it was pretty quick. I got up too fast after and fainted, (combination of the pain and dizziness) which was pretty embarrassing. I plan on getting it again when this one expires, and I would probably ask my doctor to prescribe some kind of muscle relaxer/ pain medicine I could take before going to get it inserted, if at all possible.
Also, I haven’t had a period in two years and I certainly don’t miss it!

I have the mirena.

My periods have not stopped, but in the two years I’ve had it, they have gone from 8 day long, heavy painful periods (ugh) to 2-3 day very light periods. So, needless to say, I love it. A lot.

I had always used the pill up until I had my son, and my OBGYN suggested I give it a try and I’m so glad I did.

I experienced minimal pain, but it was only for a minute. I was still recovering from childbirth/c-section so I think the pain of the mirena insertion was nothing compared to what I’d already been through. I imagine I might find it more painful now.

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