It's NOT thrush

August 11, 2010 8:30 AM

A question about IUD/the Coil - persistent infection and removal.

I've been having recurring infections for the past two years - since I broke my foot and couldn't shower so easily, thinking about it.Symptoms are itching, yellow/brown/greeny discharge, and an unpleasant smell that is sometimes like bread. sometimes sort of fishy, sometimes kind of vinegary. Doctors have given me treatments for everything from thrush (yeast infection) to bacterial vaginosis - sometimes symptoms have been alleviated for a while, but never go away. I have been back to the doctor again and again. I just changed my GP as I've moved, and she suggested it was either chlyamidia (I've had the same partner for three years) or 'discharge before period'. The biggest problem is that I can't have vaginal intercourse - it is just not possible to insert a tampon up there, never mind anything bigger.

I saw a gynaeocologist last year who suggested taking care over what toiletries I use as it may be a form of dermatitis. I've done that - I have dermatitis elsewhere so it was easy to try - but this doesn't explain the discharge. I'm going back to see them next week (I'm in the UK so we have to go through our GP to see a gynaeocologist). Last time I was there he mentioned that possibly the coil might be making a difference and it could be worth looking into removing it. I've had my coil since September 2007, not long before the infections, and at this point I feel like I just want this problem out of my life so I'm willing to consider this!

However, I'm concerned that it isn't physically possible given that last time I had tests done they couldn#'t even insert a child's speculum. It's not a case of bearing the pain - I'm well aware that it's necessary to be done - but not only is it really painful but the skin won't 'give'. Given how insertion involved opening the cervix I have no idea how they'd be able to get it out - I can't even have diagnostic tests performed correctly because of this problem, never mind access all the way up.

I'm also feeling really panicky and shaky just thinking about this, which doesn't help. I remember the pain getting it in and have heard removal is worse.

Has anyone had experience of this? What helped and how did you do it?

posted by anonymous to health & fitness (9 answers total)

I feel for you!

I agree you should get it removed, and soon. Ask the doc to give you something that will help you to relax when they take it out and to use lubricant, you could also take some ibuprofen a couple of hours before you go. My recollection from years ago was that they came out easily, but everyone is different.

If possible, have a female friend or family member go with you to the appointment, someone who can stay with you throughout and ask the questions you want to ask but are too tense, scared, or shook up to ask.

I hope you feel better soon.
posted by mareli at 8:41 AM on August 11, 2010

IANAD.

I don't understand; it doesn't say whether you were diagnosed with a specific infection, only that you've been treated for "everything". Discharge/smell is normally a clear sign of infection. Have you been tested for trichomoniasis? That's usually something the doctor can SEE, but it's worth it to ask.

Here in the US, we have specialists who deal with vulvodynia and vulvar vestibulitis. I suggest you ask your GYN for more information about seeing someone for your specific issue if you haven't found an infection.

I have no specific advice about your IUD, only that you should definitely see someone about your problem instead of just allowing them to blindly treat you.
posted by two lights above the sea at 8:41 AM on August 11, 2010

Does your IUD have copper in it, or is it solely hormonal? IANAD, but what you are describing sounds like it could be an allergic reaction to the copper that is found in many IUDs. I agree with mareli that you should have it removed. Ibuprofen an hour or so before you go and bringing someone to hold your hand are both good suggestions!
posted by shamash at 9:01 AM on August 11, 2010

From the OP:

Hi - I've been given thrush treatments after blind swabs showed evidence, but the problem is it's really hard to do any diagnostic tests because of the pain. they need to swab high up, and they can't, because no speculum will go in there. I've been given treatment for Bacterial Vaginosis and thrush, and also another antibiotic - no real change. I am seeing the gyn at something called 'chronic pain clinic' which I was told to go to if treatment didn't help. I feel so miserable about all this and i just want someone to find out what's wrong.

posted by jessamyn at 9:07 AM on August 11, 2010

I think we're missing something here - you're saying you can't have vaginal sex and doctor's can't fit even a child's speculum into your vagina for tests. Is this because you are tensing up or because you have a physical condition like vaginismus that prevents insertion? When they originally inserted the IUD, how was that done?

They should be able to remove it, and it does sound like it's causing issues for you, so probably should be removed. If you're not having vaginal intercourse anyway, it seems like the risks of having an IUD outweigh the benefits for you. Also, tell your doctor that you are anxious about the pain. Perhaps they can give you a sedative or anti-anxiety medication for the procedure.
posted by bedhead at 9:10 AM on August 11, 2010

Does your IUD have copper in it, or is it solely hormonal? IANAD, but what you are describing sounds like it could be an allergic reaction to the copper that is found in many IUDs.

Or possibly to the nickel that is in some copper IUDs, or perhaps even silver; both metals are used to stabilize the core of many IUDs, and nickel sensitivities are very common. You're in the UK, where there are a handful of copper IUD varieties available, so it might be a good idea to look into whether yours specifically contains some other metal in addition to copper and investigate from there.
posted by thisjax at 9:11 AM on August 11, 2010

I think we're missing something here - you're saying you can't have vaginal sex and doctor's can't fit even a child's speculum into your vagina for tests. Is this because you are tensing up or because you have a physical condition like vaginismus that prevents insertion? When they originally inserted the IUD, how was that done?

I think the OP is saying that whatever the problem is that's causing the odor/discharge has also caused significant pain such that her doctors cannot insert a speculum or even swab high up inside the vagina. It also sounds like it's not just pain but also a physical narrowing.

OP, can you talk to your doctors about possibly having some kind of anesthetic for further diagnosis of the underlying problem and/or removal of the coil. Possibly an epidural? I agree that it sounds like whatever the problem is, the coil is almost certainly exacerbating the issue and should come out and probably very soon.
posted by devinemissk at 9:43 AM on August 11, 2010

FWIW, I getting my (copper) IUD taken out was SIGNIFICANTLY EASIER than getting it put in. Insertion involved pain and poking and pinching and all that; removal involved the nurse (it wasn't even a doctor's appointment, I had it done at the well woman clinic) pulling the strings with a pair of little tongs (are they automatically called forceps in a medical situation? whatever. small things. no poking pinching nastiness). It came out, she dropped it in the bin, all done.

In your case it may be worth asking if it's possible to get some kind of medication, possibly in advance, muscle relaxant and/or local anaesthetic, whatever they think is best. If your GP is unhelpful, talk about the pain with a practice nurse instead. One little trick I've heard of to help relax your vaginal muscles is to open your mouth and concentrate on keeping your jaw relaxed - you know how it's utterly unhelpful when things like tampon instruction leaflets include the phrase 'try to relax your vaginal muscles'? This kind of displacement seems to work better.

I'm not anybody's medical professional, but I suspect that if you have some kind of damage (e.g. allergic reaction to something) or infection, that may cause muscle tension as a side effect, totally outwith your conscious control, and so the resulting pain when people try to see what's going on would have multiple sources, so if you can do something about the muscle tension alone it would still hurt a bit from the allergic reaction or whatever, but not nearly as much.

FWIW, my IUD caused spotting and increased discharge. It often smelled pretty nasty; it felt to me as though one of the ways the IUD worked as a contraceptive was to make me feel utterly unsexy, resulting in less sex. After it was removed the post-sex and ovulation spotting vanished, as did the nasty smell. Good luck.
posted by Lebannen at 11:15 AM on August 11, 2010

I had an IUD removed. It was less than 10% of the discomfort I had when it was put in. They don't have to dilate the cervix to do it, there is just a tool they use to take it out. I will never forget the pain I had when it was put in, even though that pain was brief. I've completely forgotten the minimal discomfort of getting it out. However, I don't have the physical problem with speculums you mention. If it is just pain due to physical smallness and not because of an infection itself, have you tried using dilators? This might be a good way to work up to the IUD removal and also make you less scared of having it done.
posted by treehorn+bunny at 6:24 PM on August 11, 2010