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The Paragard is good for you, right?
November 29, 2012 1:50 PM   Subscribe

I'm getting a copper IUD next week, yay! I did a little too much background reading about it and am now totally psyching myself out, boo! Can you talk me back into being excited, or at least calm, about this decision?

I'm in my mid-20s, nulliparious, and in a long-term monogamous relationship. I've never been on the pill because I can barely remember to take my antidepressants every day, and the only hormonal birth control I've ever tried is Depo Provera. Depo was a total mess. Not only did I have mood swings and breakthrough bleeding the entire 3 months I was on it, but I continued to spot almost every day for about 10 months after the shot supposedly wore off. Sucked.

I did a bunch of research about my options, asked my gyno about the Mirena, and was told that it would probably have a similar effect on me as the Depo. He recommended the Paragard instead, saying only that it might result in heavier periods and cramps. Since my periods aren't particularly bad to begin with and I get annoying-but-not-debilitating cramps for the first day or two, I figured that wouldn't be a big deal. I have no abnormal piping that I know of (apart from a sensitive cervix, whatever that means) and am not prone to UTIs or other similar problems.

Well, the actual procedure is next week, and I've done far too much reading in the intervening time on AskMe and Livejournal about all the things that can go wrong with a Paragard. The stories about cramping so much you had to lie down for 4 days after the procedure, of heavier and heavier periods for months until it was just removed altogether, of the possibility of copper poisoning and pain during sex and weight gain and anemia and AHHHHHHHH.

Back in the good old days when I was rational, I (and my doctor) clearly thought this was the best decision for me, but now I'm so anxious that I'm tempted to call and cancel my appointment altogether. I know people who are happy with their experience don't tend to speak up as much as people who really hated their experience, so there must be more happy stories about the Paragard out there. Please, tell me about how awesome my life is going to be.

Alternatively, if YANMD but are convinced that I'm making the biggest mistake of my reproductive life, feel free to tell me that, too.
posted by Be cool, sodapop to Health & Fitness (35 answers total) 4 users marked this as a favorite
 
YMMV. My Paragard insertion was awful, and followed by two years of hell. I had terrible cramps all the time, so much so that if I got one while I was cooking I would have to leave the kitchen and lie down for hours. My previous OB/Gyn continued to tell me it was normal.

I switched doctors, and found one who told me to just try the Mirena. I have never done well on HBC. Like I've tried several pills and all have gone very badly. He told me just to try it. He gave me local anesthesia for the insertion, no pain at all. I've had the Mirena for about five months now, and absolutely love it. I haven't had ANY side effects aside from some very slight bloating at the beginning. I spot a few days a month (tmi!?), maybe 2-3, but it's nothing like the 17 day periods I had with Paragard.
posted by roomthreeseventeen at 1:58 PM on November 29, 2012 [3 favorites]


And, on the other end....it hurt, for like 8 seconds. And I haven't really thought about my paraguard since. Because, for me, it's awesome.
posted by atomicstone at 2:06 PM on November 29, 2012


I had a Paragard placed in early September! Like you, I have naturally easy periods with almost no cramping, and am in a monogamous relationship.

I'll say up front that my experience has been good overall. The insertion was not that bad, in fact I remember asking "wait, that was IT?" I took it easy that day and was back at work the next day.

My periods are worse now. I actually never really had cramps at all before- now I will get them for a couple of hours in the day before my period starts, and my only previous symptom of lower back ache now last longer than it used to- a couple of days. This sucks but is bearable, especially with a heating pad, and really the cramps go away pretty quickly. I THINK the cramps were better this past cycle, but sicne it's only been like three months, I can't say for sure if that will continue to be the case. My flow is heavier than it used to be, but doesn't seem to last significantly longer. I use a Divacup, and haven't had trouble with it so far.

The freedom- both sexual freedom and freedom from hormones- is unbelievable and absolutely worth the cramps, to me.
posted by showbiz_liz at 2:06 PM on November 29, 2012 [1 favorite]


I got my Paragard when I was 26 because I can't use hormonal BC (cancer risk). Insertion was not a walk in the park, but it was also not really that bad. I did have some cramping and spotting for a few days afterwards.

The first few months weren't great but then something happened and the cramping just stopped. I barely cramp during my periods anymore, but the bleeding is still heavier than I remember. (It's hard because my periods weren't really regular after chemo, so it's hard remember what it was like pre-cancer.) It's been 4 years, and really no problem.

If you go through with it, definitely take it easy on yourself. I foolishly thought I'd go to work afterwards. I did go home an cuddle up with a heating pad and ibuprofen.
posted by kendrak at 2:07 PM on November 29, 2012 [1 favorite]


Oh holy crap - I got my copper IUD almost 4 years ago now and it's seriously one of the best decisions I've ever made. I'm almost kicking myself for not doing it sooner! FWIW, I'm in my early thirties and have never had children. My doctor didn't even blink when I asked her about this.

I LOVE that I'm not pumping my body full of crap. It's effective and safe and is one of the oldest forms of birth control. It's ridiculously cost effective and lasts for 10-12 years. No going to the pharmacy! NO maintenance! Just make sure you can still feel the strings and that nothing is poking out once a month. DONE. My current partner and several other partners have never complained about feeling the strings and they ran the full...*ahem* spectrum. Just be sure to use protection though because it doesn't guard against STIs.

As for periods - mine actualy got lighter with the IUD. I never really got cramping with my PMS symptoms, and it's remained the same. The insertion process was just a pinch. I literally had it done on my lunch break. No issues whatsoever. Best. Decision. Ever!

It's SO easy. I love mine!
posted by floweredfish at 2:09 PM on November 29, 2012


Really happy with mine, 10 years later. I did experience more cramping and heavier flows, but (a) I had very light periods and little cramping before, and (b) moved into perimenopause while having the Paragard, so there's an extra variable in there.

Get someone to drive you home after insertion, though. I wouldn't have been able to drive or to sit on public transit, mostly because I wanted to curl up.
posted by catlet at 2:14 PM on November 29, 2012


On my second Paraguard. Had the 1st one 10 years, like they said. Love not being on hormones. First period after insertion was longer and a tad crampy(not crampy normally) Did slow measured breathing during insertion(s) and ta-da! A friend of mine just had one placed who's a huge pain weenie. They didn't complain a bit. Here's to a happy experience!
posted by PJMoore at 2:17 PM on November 29, 2012


I loved loved loved my Paragard; only had it removed because my uterus had to go (unrelated). I made the choice to switch to IUD because I wanted off the pill and to steer clear of other hormonal birth control. I was 27, no pregnancies, when it was inserted. I think I took 1/2 a Vicodin before the procedure, but the whole thing was unremarkable. I had it done at Planned Parenthood Golden Gate.

Maybe for the first six months, of my 5 years with the Paragard, the cramps were a bit much and I bled for a good 7 days each month. But then it became totally normal--better than what my normal had been, actually--a regular ~5 day period and lots of sex with 0 babies resulting.

Both my younger sisters have had theirs for several years and don't have any particular complaints about them.

I loved mine. Maybe trust your rational self and the decision you made with your doctor, and go through with the appointment and give it a chance. The insertion isn't necessarily traumatic, and if you decide it's not for you, you can have it taken out. And if you keep it, it's very likely you're life is going to be TOTALLY AWESOME.

Good luck!
posted by strivesc at 2:17 PM on November 29, 2012


I am on my second Paragard! I had the first in for not quite 10 years, and while it was giving me no trouble, doc thought it was time to replace it. Second has been in 4 years.

I had no pain or discomfort with the insertion itself. With the first one, had heavier periods for a couple cycles, then it calmed down to normal. With the second, had maybe one heavier period.

I love my IUD. Never have to think of anything. It just works. I hated what artificial hormones did to my moods. I feel so much more like myself without them.
posted by agentmitten at 2:21 PM on November 29, 2012


On my second IUD, have had it for years. The heaviest bleeding lasts for a few months, can continue being heavy after that, but not ridiculously heavy. Cramps also petered out after the first few months, though I have PCOS and other cramp issues.

Get a local anesthetic for insertion. I was pretty much okay the same day, but I still took the chance to lay around with a hot water bottle and watch My So-Called Life.

I really just like not having to think much about birth control, to be honest. The IUD doesn't work for everyone, just like Depo or HBC isn't the right choice for everyone. But I think it's still worth trying out.
posted by dinty_moore at 2:30 PM on November 29, 2012


I got the paragard in August this year. I had quite a bit of pain in the hours after the insertion and after the ibuprofen didn't seem to help, I took a hydrocodone I had left over from an issue earlier this year and I was happy as could be. I was fine the next day. My first period after it was inserted was HORRIBLE. I had painful, painful cramps, a long period and it was HEAVY. I've had two periods since then and they've each decreased in horribleness by multitudes. I still get light spotting for a few days before and afterwards, which is kind of annoying, but the terrible cramps and heavy flow is gone.

I put it off for too long thinking I wouldn't be able to use a menstrual cup (I had two friends who had to quit using it for some reason) and I CAN'T LIVE WITHOUT MY CUP, but I've had exactly 0 issues with that. I am so, so happy I finally made the leap!
posted by hannahelastic at 2:31 PM on November 29, 2012 [1 favorite]


I don't want to persuade you one way or another, since everyone's body is different - but - I did want to share my experiences since I see some similarities between your situation and mine.

...asked my gyno about the Mirena, and was told that it would probably have a similar effect on me as the Depo.

I'm not sure this is exactly true. From what I understand the amount of hormones in the Depo Provera are greater since they have to travel throughout the bloodstream to hit your ovaries and suppress an egg from being released. The hormones in the Mirena, otoh, can be less because they act directly to simply keep an egg from attaching to the uterine wall.

Since my periods aren't particularly bad to begin with and I get annoying-but-not-debilitating cramps for the first day or two, I figured that wouldn't be a big deal.

This is not necessarily true. I also did not have very heavy periods and very little cramping (if any) before I got the Paragard. However, once it was inserted I had the absolute heaviest period and cramps ever. I also felt an ache for about two of the four weeks out of the month. It was horrible and basically made me not want to ever, ever have sex. It sucked mightily. I finally had it removed after about a year and a half and switched to the Mirena.

I can't handle hormonal BC at all (migraines, depression) but have not noticed any of those type of negative side effects from the Mirena.
posted by hapax_legomenon at 2:39 PM on November 29, 2012 [4 favorites]


I've had mine for five years and it has never been a problem. I don't actually remember it hurting to put in, but I'm not sure if I just don't remember. (But if I don't, well, that's how minor.)
posted by Margalo Epps at 2:43 PM on November 29, 2012


Primiparous naturally-easy-periods woman here. I've had a copper IUD for six years. Even the nurse who inserted mine tried to scare me out of it ("Remember the scene with the elevator full of blood in "The Shining"? THAT."), but I am glad I went ahead with it, because I freaking LOVE it. While my periods DID get heavier, they've only ever been "normal heavy period"-heavy, not, like, plague-of-the-Old-Testament heavy. The insertion was a little crampy, but overall, it wasn't awful. And never, ever having to worry about birth control? Priceless.
posted by julthumbscrew at 2:46 PM on November 29, 2012


Got my paragard the day Obama took the oath of office. Hopped on my motorcycle, rode home. Took a nap, went to a singing class. Insertion didn't hurt for me at all. Twice a year or so I get about 15 minutes of cramps. My periods are a bit heavier, but NBD. Love love my IUD.
posted by mollymayhem at 3:04 PM on November 29, 2012


I went from Mirena to a Paragard after having issues with ovarian cysts (apparently Mirena can increase the risk of cysts). Like the Mirena, the insertion was not fun, and unlike the Mirena, I was mildly crampy for a couple of days afterward. After 5 years of no bleeding or cramping, I was dreading my period, but they aren't any different than my pre-Mirena periods.
posted by amarynth at 3:18 PM on November 29, 2012


I've had one several years. Insertion was painful but the pain was very brief. I had crampier than normal periods for several months after the insertion but now i only get very mild cramps on occasion and heavier but not horribly so periods.

Overall it's been fantastic. Cost effective an easy with very few side effects. I would absolutely get another.
posted by SpaceWarp13 at 3:43 PM on November 29, 2012 [1 favorite]


I was going to say something similar to hapax_legomenon... IANAG and obviously IANYG, but I'm not sure about your doctor's argument that your adverse reactions to Depo-Provera strongly suggest that you'd have similar reactions to the Mirena. Yes, it's also a progestogen-only contraceptive, but not exactly the same kind, and a far smaller dose. Those variables matter a LOT when it comes to birth control, in my experience.

That's not to say that the Paragard isn't the right choice for you. You'll probably be fine, and of course the internet is way more full of horror stories than it is with positive outcomes. But if you're really waffling, you might be interested to know that that active ingredient in the Mirena, levonorgestrel, comes in oral formulations (it's what's in Plan B, for one, although of course I was referring to regular daily oral BCP). So you could conceivably "try before you buy," to some degree, which is not possible with the Paragard. (I know you said you had trouble remembering to take pills so apologies if this is not a helpful thought, I just know that I personally became more comfortable with the idea of the Mirena after having taken oral levonorgestrel with no problems.)
posted by slenderloris at 4:22 PM on November 29, 2012 [1 favorite]


I had issues with hormonal BC, but none with Mirena, so like someone else above, I think your doc has seriously overstated when equating Mirena with Depo.
posted by woodvine at 4:50 PM on November 29, 2012 [1 favorite]


I have had my Paragard for about five years now and at this point I'm so sick of it I feel like yanking it out once and for all. I never used to have heavy periods and now literally every single month I'll have an accident. While this is merely an annoyance, a more serious side effect is that after years of this my blood iron reserves dropped into the single digits and I had to start a supplement regimen to make my hair stop falling out (read up on ferritin, related to hair loss in women). Iron supplements have their own side-effects (constipation), so it's not an easy problem to deal with.

My advice would be: if you are concerned about anemia and/or hair loss think twice.
posted by Dragonness at 5:09 PM on November 29, 2012


I'm also in my mid-20s, nulliparious, and in a long-term monogamous relationship. I have Paragard for about 8 months now and I love it.

The bad part: My doctor didn't insert it right the first time, though, so I had two insertions. And it really hurt the second time. And my periods were horrible the first 4 months, full of cramps (where I had none before) and looooong periods (10 or 12 days instead of 7). But I kept track of them, and found that my periods were getting shorter and the cramps were going away. Now, I have somewhat normal periods back again. I have to be more careful about eating properly in order to avoid cramps and my period is slightly heavier than before, but I've always had really heavy periods so I'm used to having to be careful.

The good part: It's painless. It's hormone free (good for me since I have to be careful about my liver). I won't forget it. And it works just as well as sterilization. They tell you to wait 6 months for your body to adjust and I feel like I've made it through that period and I'm home free now. Even if that's not the case, I paid $67 out of pocket for it, which covers the 8 months of birth control anyway.

I did not suffer from copper poisoning or weight gain or anemia. I think I possibly had depression for 4 days...? (My mood was unusually off, but I couldn't tell why.) And that's sometimes related to extra copper. But I eat A LOT of dark green veggies which are supposed to be high in iron (benefit of dating a vegetarian) and it went away quickly.
posted by ethidda at 5:22 PM on November 29, 2012


I agree with the other posters regarding the Mirena. My doctor downplayed the progesterone aspect, and implied it wouldn't secrete as many hormones as you find in a hormonal birth control method. And the Mirena is really really great. Easy to go in and no periods! Yay! I would try to get more information comparing Depo and Mirena to see if they are truly comparable. I don't know anything about Paragard, so I can't comment about that.
posted by bluespark25 at 6:42 PM on November 29, 2012 [1 favorite]


I love (love love LOVE) my Paragard, just so you know where I'm coming from.

The discomfort I experienced during installation was fairly minor and brief. I actually had to have it done twice because the first time it slipped out of place after a day or two. (I've written about that on AskMe before.) Under the heading of "things that hurt worse": menstrual cramps, bad intestinal gas, getting my cervix bonked during penetrative sex.

From an earlier comment of mine about the IUD:
Although my periods got heavier for the first four to six months after having the IUD inserted, they've since gone back down to their previous fairly light level. I feel much more in touch with my body's cycle (understandably, since the hormonal birth control was pretty much squashing said cycle flat), and these days find that paying attention to my libido's level helps me know where I am in my cycle. (When my libido abruptly goes to sleep, I know my period will arrive in a day and a half or so; mid-cycle, when I assume I must be ovulating, it definitely surges, which my husband appreciates.)
posted by Lexica at 6:47 PM on November 29, 2012


I'm a little late on this but I love my IUD so much I don't care. Best bodily decision I've made. I am 23, never been pregnant, and in a long-term relationship. Like you, I psyched myself out by reading vagina_pagina horror stories on livejournal and freaked out on metafilter.

The day of my planned parenthood appointment I panicked. What if it pokes holes in my uterus and falls out or what if I can feel the stings all the time and they scratch??! Thankfully I had a sweet old nurse who pretty much told me to stop over thinking the damn thing.

The worst part of the procedure is the speculum. They give you a tiny little shot and cover your cervix with this bright red cherry flavored (?!) numbing cream. Then there's a little DEEP pressure, you'll want a hand to squeeze, and it's done.

I had cramps and spotting for 2-3 days after which weren't anything worse then a moderate period. I had light periods every three months or so and now they're nonexistent.

I know this isn't the most typical or widely known experience, but it happens. Good luck!
posted by Marinara at 6:59 PM on November 29, 2012


Mid-30s, never been pregnant, and I've had the Paraguard for almost four years. I was coming off hormonal birth control when I got my IUD so my periods were likely to be heavier anyway, and for the first few months they were definitely heavier and crampier but not unmanageable. They've pretty much returned to normal now. I believe I took extra strength ibuprofen ahead of the insertion (which was uncomfortable but quick), took public transportation home, and spent an evening curled up with a hot water pad. I was fine the next day.
I love love love my Paraguard, and really wish I'd gotten it years before.
posted by ants at 6:59 PM on November 29, 2012


The IUD Divas LJ community is REALLY helpful for real world stories (and lots of them).
posted by Addlepated at 6:59 PM on November 29, 2012


I was one of the people who had the paraguard and had an awful experience with it, from insertion pain to incredibly heavy and painful periods to painful intercourse. I kept it in for over a year, because everything I read said it can take that long for your body to normalize, but it just wasn't for me.

But, even as I was going through that, I fully understood that my experience wasn't that common. I am feeling some envy reading through all these rave reviews (because I really wanted it to be that way for me, too!), but I have no desire to try and dissuade you from trying it.

I think it is a great choice for birth control. I think that trying it is a great idea for you, especially if your doctor is on board. If it doesn't work out for you, well, then, you can just get it removed and try something else. Chances are really, really good that it *will* work out for you, though, and you will be so glad you did it.

Give it a full year for the side-effects to subside; I bet it won't take that long, though. And even though my experience sucked, I did not gain weight from it and I did not get copper poisoning (which is an incredibly rare side-effect anyway).
posted by Brody's chum at 7:54 PM on November 29, 2012 [1 favorite]


People can be very histrionic about IUDs, while accepting all sorts of bullshit from other kinds of birth control. But I loved my Paragard. Life is a lot stupider without it right now. It sucks having had the freedom of an IUD for several years, and then having that freedom go away!

Insertion wasn't fun, but it wasn't that bad. I went tromping through a nature park right afterward, with no problems. My periods were weird for a while (heavier, longer), and then they settled down. Ibuprofen helps with this; ask your doctor about that. No anemia, and I am prone to it. No weight gain. Can't speak to UTIs, because I am somewhat prone to them, and that didn't appear to get worse or better due to the IUD.

We didn't have issues with pain during sex. Do you mean when the guy's penis gets poked by the string? Don't have them cut the string very short. Mine was left long, and harmlessly curled up next to my cervix most of the time. After the string softens up, the poking problems tend to come to an end.

Several things you're worried about are so unlikely that even a severe hypochondriac like myself never worried about them during the entire time I had the IUD. I would suggest that you stop reading the horror stories. Do you know how many of those stories are completely freaking false? A year or so ago, I read about some woman claiming that MRIs melt Paragards in your uterus, and that they have to remove charred debris from you afterward! People are just making up crap out there! (If you want extra proof, I had an MRI when I still had my Paragard, and nothing happened. Of course.)

I also want to agree with the people who are telling your doctor appears to be overstating the hormonal side effects of the Mirena. There are hormones in it, but they are much more localized and the dose is lower. Most of the women I know with IUDs have Mirenas, and they are as happy as I was with my Paragard.

I had to have my Paragard taken out (for reasons that aren't relevant to your case), and I hope to get another one as soon as I can afford to do so. I am an IUD convert for life, and Paragard is my IUD of choice.
posted by Coatlicue at 8:40 PM on November 29, 2012


I have a Mirena, so while I can't commiserate on the post-installation particulars, I was also super nervous about getting it put in. My general approach was to stop thinking of it as something I could cancel, but to view it as a non-elective procedure that I needed to get (i.e. surgery for appendicitis, how I would currently view abortion, getting my wisdom teeth removed, etc.). By casting it as something that wasn't an option, but was a requirement, I was able to get myself much more psyched up for the appointment.
While the placement hurt like a bitch for 45 seconds or so, getting an IUD was an awesome decision and I would (and plan to) totally do it again. Good luck!
posted by hefeweizen at 8:48 PM on November 29, 2012


It hurt like blazes getting my copper IUD put in, and I spent the rest of the day with a hot water bottle and ibuprofen, but I'd get it done again like a flash. I do have fairly heavy periods and cramping but mine have always been that way anyway—I wouldn't say they're much worse now. I also have no trouble using a menstrual cup. Hormonal birth control wasn't suitable for me and the peace of mind from having a 99%+ reliable, no maintenance needed contraceptive is wonderful. Of course ymmv but I wanted to add more anecdata to the positive side.
posted by daisyk at 1:39 AM on November 30, 2012


I forgot to mention that I was freaked out about switching to the Paragard. I had done a lot of reading about it, and so had my partner, and what made me feel better was discussing alternative birth control plans with him in case the Paragard couldn't be inserted or I had to have it removed at some point. Because of that, I was able to move from, "OMG, what if this or that or this other thing happens," to "If that happens, we'll just pull that sucker out and do the other thing, NBD."
posted by amarynth at 5:34 AM on November 30, 2012


YAY. Thank you everyone for sharing your stories. This is awesome and exactly hit the spot.
posted by Be cool, sodapop at 8:31 AM on November 30, 2012


Oh, and the Mirena/Depo thing is something that I've thought about and researched previously as well, which is why I asked for it to begin with. I was a little surprised the doc wanted to write it off right away, but if this doesn't work out I'm definitely open to trying the Mirena instead.
posted by Be cool, sodapop at 8:35 AM on November 30, 2012


I agree that mirena should be an option or you, only because I went to my doctor asking for the paragard due to not wanting hormones. She was a huge fan of the Mirena and said that the hormones are local to the uterus only and nothing to worry about. So I'm surprised your doctor has a different conclusion.

But I wanted to talk about the insertion... It was not bad AT ALL, and I was pretty freaked out about the whole thing. I have never delivered a baby (c-section only), so she gave me a Misoprostal pill to insert the night before. This was to help soften the cervix. The next day, she used a local anesthetic to numb the area, something she does for nulliparious women. That part was a little freaky, because she used a Huge ass needle to do it, but I had NO pain with the insertion. None! I was supposed to feel some cramping or pinching, but this didn't occur. I highly recommend asking if this is an option for you.
posted by smalls at 9:51 AM on November 30, 2012


Reporting back! The insertion was an absolute motherfucker, as everyone said it would be. I basically felt like something was grabbing at my insides and twisting them for the entire duration. The doc had to dilate my cervix which was kind of like a punch to the gut (never. having. kids.), and he seemed to be having trouble getting it deep enough to get it inserted, but everything eventually worked out.

I asked about a local anesthetic, but the doctor said he'd never used it in that procedure "in 23 years of experience", so I guess that was out.

Once it was in, the cramps weren't super bad, but they were annoying enough that I decided to take the rest of the day off of work. (Plus I was still a little shaky from the insertion.) I had hydrocodone on deck, but I made do with OTC ibuprofen and judicious application of self-pity and that seems to be working so far.

Thanks again to everyone who took the time to answer!
posted by Be cool, sodapop at 11:17 AM on December 7, 2012


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