Switching IUDs?

February 2, 2015 4:42 PM

Should I give up my Skyla IUD for a ParaGard?

I got a Skyla IUD three months ago, and it has been non-stop problems. I really hate it and want it out, but everyone keeps telling me to give it more time. I'm wondering what people's experiences were and if I should indeed wait or give it up now.

I have spotted every single day since I got save three days. Some days it is heavier and some days lighter, but I have had to wear a pantiliner every single day since it was inserted. I know this is a normal side effect but it still seems like way more spotting than most people have had to deal with. I switched to an IUD because I was spotting three weeks out of the month on the pill, so this is disheartening.

I also have broken out in cystic acne all over my chest and back, which my derm said was from the IUD. She prescribed me spironolactone, which I took for several days but it made me wake up 3-4 times a night to pee and also made me start to spot much more heavily. (I'm waiting for a call back from her to see if I can take the whole dose in the morning to eliminate the nightly awakening effects). I've modified the clothes I wear because the acne is so bad.

I also feel it has had an effect on my moods, though this is really hard to say objectively. But basically, I have hated it since the day I got it. My gynecologist said I could potentially spot for all three years while on it, which doesn't really give me a lot of hope. I want to get it removed and try the copper IUD, but I am concerned that it won't be much better. I have a history of very painful periods (though not all the time, just twice in my life that they were bad enough to make me vomit). I do have light periods typically. I would happily trade the constant spotting for a couple days of misery every month. And having to take a prescription pill twice a day (spiro) that costs the same as BCP and has other side effects kind of negates the whole point of having an IUD to me.

Has anyone made this switch and been glad they did? What are people's experiences with the copper IUD like, especially if you had a history of (sometimes) severe cramps? I want to make the switch but I am scared I might regret it :/

Thank you!

posted by queens86 to Health & Fitness (18 answers total)

I have a history of very irregular periods and sometimes severe cramps. My Paragard was great for about a year, until I got the Surprise Six-Week Heavy Period. I should call it the Idiopathic Surprise Six-Week Heavy Period, because its cause was never really identified, if it had a cause. I replaced the Paragard with a Mirena (low-dose hormone IUD) and I no longer have a period, period. Maybe you started with the equivalent of a Mirena, though; if so, ignore that part!
posted by chesty_a_arthur at 4:47 PM on February 2, 2015

A copper IUD doesn't sound like a good choice for you. Its side effects also include spotting between periods (in addition to longer, heavier, periods). If you were on BCPs before the IUD, the acne is likely not DUE to the Skyla, but due to lower levels of systemic estrogen, which wouldn't be improved by the copper IUD (if anything, it would be worse).

I'm sorry you're having such a terrible experience. It sounds like the Skyla is just a failed experiment. I don't know if Mirena would be an improvement (higher progesterone levels, but not sure if it causes higher serum progesterone or not). What didn't you like about the pill? Nuvaring might be worth a try (more convenient, but still controlled acne and spotting for me).
posted by i_am_a_fiesta at 4:49 PM on February 2, 2015 [1 favorite]

I did a lot of research on IUDs before choosing the Paragard. I did NOT want hormonal birth control. I am very, very happy with my IUD. I have had it for about two years and I really like it.

I mention the research because the studies I found concerning side effects with the Paragard showed that about 33% of women experience no change, 33% have heavier periods, and 33% have lighter periods. So, it is fairly evenly split and you don't know what camp you'll fall into until you try it. Your periods may be heavier, yes. But like you, I was HAPPY to trade a few days of "misery" to not be on hormonal birth control, and I am sure glad I did it. And I am not miserable during my period, at all.

My periods are more painful and heavier than they used to be, but they used to be very light so that is not saying much. Now I have two days of heavy flow where I do have to wear a super tampon and change it once or twice a day; before, I just wore pantyliners and occasionally a skinny-mini tampon all day long. I now take an extra-strength tylonel the day it arrives and the pain is totally bearable. It's nothing like it was way back when I was young -- I had such painful periods I couldn't even walk around and would vomit and stuff, and that all changed when I went on the pill.

Research shows that it takes 3-6 months for your body to normalize but if I were you I would have it taken out yesterday. Three months of spotting is awful and you don't have to experience that. And the acne, and having to take another medication twice a day, and, and, and... no thanks.

Good luck. I'm so sorry you have to go through this.
posted by sockermom at 4:52 PM on February 2, 2015

I'm on week 4 of spotting from my Mirena having similar misgivings. I had the same problem with the mini pill; it's the same progesterone-only thing. The combo pull worked so, so much better for me, with light, short periods and no spotting ever. I'm only not on it now due to breastfeeding. Are you contraindicated for it? Have you tried it? Sorry to not really answer your question, but I thought maybe this would help.
posted by olinerd at 4:52 PM on February 2, 2015 [1 favorite]

My Paragard story: I had it for 8 years. I had previously had what I'd guess are average periods in regards to flow and cramps. My periods got much heavier and much, much crampier. Most cycles I'd have 1 day where I basically stayed in bed due to terrible cramps and heavy flow. I guess the reason I put up with it so long is I have PCOS, so I only had about 6 periods a year and the desire for non-hormonal birth control. I was really happy after I finally got it removed and wish I didn't wait so long. I'm not adverse to trying another IUD, but I'd go with Mirena if I ever go back on a form of birth control.
posted by disaster77 at 4:56 PM on February 2, 2015

Response by poster: Sorry, yes, to clarify Skyla is basically a lower-dose Mirena. I was off BCPs for six months before getting the IUD and my skin was fine, it was just about a month after getting Skyla that I began to break out. I think Mirena would cause the same issues as it also has progesterone (which is what's causing the acne).

On the combo pill, my skin was great but after a year or two on it I started to spot for three weeks out of the month, despite being on the highest possible dose of estrogen. I am guessing that any progesterone at all causes me to spot, but I'm not sure.

Thanks for the answers so far, please keep them coming!
posted by queens86 at 4:56 PM on February 2, 2015

Before I got my first and only IUD, a Paragard, I had fairly regular periods without much cramping at all. After I had it inserted, I had hellacious cramps for at least a year, if I remember correctly. Periods got heavier for a while but nothing untoward. I waited it out and now I get the occasional cramp but otherwise forget it exists. It's been about 7 years now. I found IUD Divas on livejournal to be a great resource. Not sure if they are still around; when I'm not on my phone I will hunt up a link.
posted by prewar lemonade at 5:07 PM on February 2, 2015

My previously light and easy periods were near-constant and unbearable on the copper iud. I gave up after 6 months.
posted by Dashy at 5:29 PM on February 2, 2015

I've had a Paragard (copper IUD) for almost 4 years and I really like it. When I first got it, my periods did indeed get a little heavier, and I did have worse cramping (maybe like 7 on a 1-10 scale of pain, compared to 3-4 in my pre-Paragard days). But after about 6 months things settled down and now I'll have maybe 1-2 days of uncomfortable (definitely not miserable) cramps a month, and it's pretty much taken care of by some ibuprofen. I forget it's even there most of the time. It might be worth waiting it out with the Skyla and/or getting a copper one but realizing you might have an uncomfortable first 6 months with that one too.
posted by aka burlap at 5:32 PM on February 2, 2015

If it helps, I spotted for about six months after getting the Mirena. It did finally stop, though. I understand that the copper IUD makes periods heavier in many cases, and is equally if not more
likely to cause spotting.
posted by artemisia at 5:38 PM on February 2, 2015

I had a terrible time with Paragard, and my doctor kept asking me to give it a little longer. Well, let me tell you, after two years of that crap (and it involved often paralyzing cramps where I would have to get up from whatever I was doing and lie down for hours), I switched doctors and IUDs. I switched to Mirena and since then have not only had no cramps, but no period, no mood swings, no weight gain, etc.

tl;dr. Listen to your body and switch. Try something new.
posted by roomthreeseventeen at 5:46 PM on February 2, 2015

I got my Skyla about a month ago and love it. This was after I had a Mirena and got it removed for side effects I didn't like (mood swings etc). Three months is about the amount of time they say it takes side effects to go away if they will. You're right at that border, so I would say give if another couple weeks to a month and see if anything changes.

As a note on the breakthrough bleeding, though, I'm definitely getting some with the Skyla, whereas the Mirena was almost nothing after a month or so. Becauee of the lower dose of Skyla, it doesn't make your period stop and had a lot more spotting.

I had a big internal debate (with input from my regular GYN and the dr who inserted my IUD) about the benefits/negatives of the Skyla vs Mirena vs Paraguard. I decided for my body, the side effects I would get with Skyla would be preferable to the Paraguard. Im very pleased that the only side effect I've gotten is spotting. But I can tell you, if I was getting other side effects I would consider removal. Getting my Mirena out was a wonderful choice.
posted by DoubleLune at 5:56 PM on February 2, 2015

I was going to recommend the Mirena but it sounds like it may well not be the best option for you, considering your current IUD seems to be giving you so much trouble! I'm a big fan of mine as are most women I know (well, six specific people to be exact) who have had a lot of success with theirs after an initial six-month adjustment period, give or take. That said, it sounds like another BC option might be more ideal for you. Did you ever take another form of hormonal BC before? If so, how was that?

How long have you been taking the spironolactone? I ask because it can take awhile to become fully effective; however, if you've been taking it for three months, then I'd say it's been enough time to tell. (Disclaimer: this is all anecdotal as my medical knowledge is definitely amateur.)

How are things in your life otherwise? Any other stressors or health changes? Have you considered seeing a dermatologist for a second option about the acne? What about checking with your GP to see their thoughts on your IUD's apparent side effects?
posted by smorgasbord at 6:52 PM on February 2, 2015

I have had my Paragard for almost 6 years. I absolutely love it. Previously, I had tried Depo (gained 50 pounds, no libido, etc), several types of pills, the patch, NuvaRing, and condoms. Hormonal BC and I don't mix, my (long-term) partner has issues with condoms, and I have always known I don't want kids, so a copper IUD was the obvious choice. In 2019, I will have this one removed and a new one inserted.
I have ALWAYS had heavy, irregular periods with awful cramping, as in, since I began menstruating at 11 years old. The only time it ever stopped was with the Depo. My gyno and GP have determined that I do not have PCOS, despite these and other symptoms. I have also always had less-than-stellar skin, so that was hormonal BC's only saving grace for me.
That being said...my periods with my Paragard are certainly no worse than they were before I had it inserted; in fact, they are almost now more predictable and yeah the cramps suck, but they only last one day (the day before I begin) instead of the entirety of my 5-7 day period. No, that's not a typo; it's always been that long. My skin still sucks. But I will have crappy skin over 1) babies 2) extreme weight gain 3) no libido whatsoever.
TL;DR - YMMV, but I love my Paragard. It didn't seem to have a negative impact on my menstrual cycle.
posted by sara is disenchanted at 6:59 PM on February 2, 2015

I had a Paragard inserted a week ago after a two-year downward slide with a Mirena (mostly mood related side effects, and like yours, just subtle enough to question whether they were real). I took a 4 month break from anything besides barrier methods, found my mood improved (in winter, even!), and after some handwringing, got the copper IUD. I'll be giving it 4-6 months before I make a call on whether it's even maybe a keeper.

Using my own body and mind as an experiment is extremely frustrating, since y'know, my life is still happening here in the meantime. But as a 30-something with no kid plans, a 10 year nonhormonal IUD will be ideal if it works out, so I'm taking it as methodically as I can, here, and trying not to let my frustration lead me to changing things up too fast or feeding my inaction via feelings of hopelessness. Birth control is so very YMMV that personally, I think that's all any of us can do. If I were you, I'd wait another 1-3 months, but have an appointment ready to make a change if things haven't improved.
posted by deludingmyself at 9:20 PM on February 2, 2015 [3 favorites]

I have been a Paragard user for several years now. One thing I will say is that my experience after having kids (planned, don't worry, the thing works like a charm) was radically better than my experience before having kids. The pre-kid insertion was terrible, I staggered around in a nauseated pain induced haze for a few days afterwards, and the periods were painful and heavy for a while too.

I suppose that now that it's hosted and ejected two children, my uterus thinks nothing of a little plastic T. The last insertion was a breeze. My periods are heavy the first couple of days, which is mildly inconvenient; I might have to take an advil the first day, and that's about it. (I used to have quite painful periods, back in the day.)

I never tried the mirena, because by the time I got to IUD I wanted to be DONE with hormones. I did not feel right on either traditional birth control pills or the NuvaRing.
posted by telepanda at 6:51 AM on February 3, 2015 [1 favorite]

I've had the Paragard for about 5 years, and my experience has been fairly similar to sara is disenchanted above, except that I didn't switch to Paragard from any thing but condoms. Granted, my periods were irregular to begin with--I didn't get them at all until I was 16, and it took several years for them to settle into happening anything like approximately once a month (initially they were mostly less frequent). For psychological reasons hormonal birth control was something I didn't want to experiment with while I was in high school and college (i.e., wanted to know in advance how stable/otherwise I would be, rather than guessing about side effects). In college I was able to become a client of a midwife/obgyn at our hospital who was incredibly helpful with talking through the options; like sockermom I'd done tons of research and came in knowing that the Paragard made the most sense, and she agreed despite my being traditionally contraindicated (no extant babies). My insertion was extremely painful but that was because it turns out I have a beyond-the-typical-range tiny uterus, so it involved a few more measurements than usual; since you already have an IUD I assume your practitioner would already know how to optimize insertion. Afterwards I had cramps for about a day, had to miss class, but by the time I had my x-ray check-up to see if it'd settled in the right place I felt fine.

My periods had always been really heavy and irregular (like, changing soaked-through overnight pads every couple of hours for the first few days of a 5-7 day period); they didn't get worse (possibly slightly longer, trailing off over a few days) and I would say after a couple of years they've actually gotten quite a bit lighter and definitely more predictable, although not much shorter. I have never had spotting *at all*, either before or since my IUD. I've always occasionally had lying-down-in-pain level cramps, maybe a few times a year; I think they were worse for the first year or so on the Paragard (for that year I definitely got generally-uncomfortable cramps for almost every period; before then and since it's all or nothing, terrible cramps or totally fine) but now I'd say more like once a year if that. So in my case, when I was initially worried about whether it was making my periods unbearable and my obgyn encouraged me to wait, that was the right advice, although it's true that I only had worse versions of the issues I already had, nothing new; if I have insurance that covers it when this one is done, I expect to replace it with another Paragard or whatever the copper IUD of the future is.

(Honestly, your story only makes me more confident in my choice, as my entire goal was to avoid messing with my hormones; I know the literature says if it starts in the right area it doesn't have to affect the rest of your body as much, but this is a case where a few anecdotes and inconsistent data were enough to make me and my obgyn wary about how true that was for people who are extremely sensitive to hormonal changes. Especially since you say your skin side effects went away when you were off BCP, it sounds like you might be in the same boat. At least the side effects of the Paragard are mostly your own business and not visible to others?)
posted by C. K. Dexter Haven at 11:00 AM on February 3, 2015

My periods pre-paragard were every 25-27 days, lasted 3 days, had moderate cramping on the first day only and were not particularly heavy. After I got the paragard my periods were 5-6 days long and incredibly heavy with the most horrible pincer-like cramps. I started getting cramps days before my period started, and had cramps throughout the 5-6 days the bleeding lasted. I also had cramps when I ovulated. And on random other days during the month just for the hell of it.

I have had friends who were on hormonal IUD's and they all said they spotted for a good 4-6 weeks after the insertion, but after that things were a breeze. No cramps and no period for most of them. Insertion is hellacious for either type of IUD for those who have never had kids. For women who have had babies, insertion is a (relative) breeze.

I would give it another 4-6 weeks. After that, if you still hate it I wouldn't blame you for having it removed. What I would not do is recommend the paragard for someone with a history of bad cramping. Every single person I know who had a paragard had it removed within 2 years. I spotted for 2 solid months after insertion. I distinctly remember going out and buying a bunch of black underwear around day 30.
posted by 8dot3 at 11:50 AM on February 3, 2015 [1 favorite]